Provider Demographics
NPI:1982795415
Name:ASHLEY, PHILIP GARDNER (MS, LCMFT)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:GARDNER
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:MS, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N. ROCK ROAD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1198
Mailing Address - Country:US
Mailing Address - Phone:316-683-4083
Mailing Address - Fax:316-689-8431
Practice Address - Street 1:2900 N ROCK RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1144
Practice Address - Country:US
Practice Address - Phone:316-683-4083
Practice Address - Fax:316-689-8431
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCMFT #322106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist