Healthcare Provider Details

I. General information

NPI: 1265151187
Provider Name (Legal Business Name): COURTNEY ELYSE ASHFORD ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 W HENDERSON AVE STE 1
PORTERVILLE CA
93257-1777
US

IV. Provider business mailing address

177 W HENDERSON AVE STE 1
PORTERVILLE CA
93257-1777
US

V. Phone/Fax

Practice location:
  • Phone: 559-894-7912
  • Fax:
Mailing address:
  • Phone: 559-894-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW139274
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: