Healthcare Provider Details

I. General information

NPI: 1861338469
Provider Name (Legal Business Name): ASHLEIGH HAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1916 W SUNSET AVE STE C
SPRINGDALE AR
72762-5142
US

IV. Provider business mailing address

933 VIA TORRE AVE APT A
TONTITOWN AR
72762-4355
US

V. Phone/Fax

Practice location:
  • Phone: 479-841-5336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2604009
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: