Healthcare Provider Details

I. General information

NPI: 1205983244
Provider Name (Legal Business Name): PATRICIA ASHLEY PHD, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3393 IRIS AVE # 208
BOULDER CO
80301-5205
US

IV. Provider business mailing address

3393 IRIS AVE # 208
BOULDER CO
80301-5205
US

V. Phone/Fax

Practice location:
  • Phone: 303-546-2810
  • Fax: 720-565-8833
Mailing address:
  • Phone: 303-546-2810
  • Fax: 720-565-8833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2565
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2565
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: