Provider Demographics
NPI:1952596223
Name:SCHACHTERLE, ASHLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SCHACHTERLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 GETWELL RD
Mailing Address - Street 2:BUILDING B., SUITE 2
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-7313
Mailing Address - Country:US
Mailing Address - Phone:662-349-2979
Mailing Address - Fax:662-349-2978
Practice Address - Street 1:5627 GETWELL RD
Practice Address - Street 2:BUILDING B., SUITE 2
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-7313
Practice Address - Country:US
Practice Address - Phone:662-349-2979
Practice Address - Fax:662-349-2978
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48901041C0700X
MSC74231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical