Provider Demographics
NPI:1912637083
Name:ASHMUS, CAITLYN (MS, LPC-IT)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:ASHMUS
Suffix:
Gender:F
Credentials:MS, LPC-IT
Other - Prefix:
Other - First Name:CARTER
Other - Middle Name:
Other - Last Name:ASHMUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC-IT
Mailing Address - Street 1:222 N FRANKLIN ST APT 303
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2987
Mailing Address - Country:US
Mailing Address - Phone:262-902-4314
Mailing Address - Fax:
Practice Address - Street 1:4700 DRESSER DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-9160
Practice Address - Country:US
Practice Address - Phone:608-752-7255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5339-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health