Provider Demographics
NPI:1912088469
Name:ASHLOCK, BERNARD (LCPC, LIMHP, LPC)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:
Last Name:ASHLOCK
Suffix:
Gender:M
Credentials:LCPC, LIMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5835 SW 28TH TER
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2423
Mailing Address - Country:US
Mailing Address - Phone:202-727-6826
Mailing Address - Fax:
Practice Address - Street 1:805 NEW HAMPSHIRE ST STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2774
Practice Address - Country:US
Practice Address - Phone:785-214-4012
Practice Address - Fax:785-212-4015
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2893101YM0800X
KSLCPC 059101YM0800X
NE3543101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health