MEDICARE: ASHLEY PIOTROWSKI PRAKASH MS, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.021391	IL

General Provider Information

NPI Number	:	1922615517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY PIOTROWSKI PRAKASH MS, LCSW

Provider Business Mailing Address
First Line	:	6023 N RIDGE AVE # 3E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-0189
Country	:	US
Telephone Number	:	989-225-2346
Fax Number	:

Provider Business Practice Location Address
First Line	:	6023 N RIDGE AVE # 3E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-0189
Country	:	US
Telephone Number	:	989-225-2346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2020
Last Update Date	:	09/28/2020

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