Provider Demographics
NPI:1841671773
Name:AKINA, ASHLEY (MA, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:AKINA
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 W TARGEE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-4227
Mailing Address - Country:US
Mailing Address - Phone:208-949-6494
Mailing Address - Fax:
Practice Address - Street 1:847 PARKCENTRE WAY
Practice Address - Street 2:SUITE 6-7
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1792
Practice Address - Country:US
Practice Address - Phone:208-467-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional