Provider Demographics
NPI:1932760709
Name:LIEBERKNECHT, ASHLEY BARRETT (LMHC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BARRETT
Last Name:LIEBERKNECHT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 PECKS CANYON RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2137
Mailing Address - Country:US
Mailing Address - Phone:509-731-6957
Mailing Address - Fax:
Practice Address - Street 1:1460 N 16TH AVE STE G
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7102
Practice Address - Country:US
Practice Address - Phone:509-731-6957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60975570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health