Healthcare Provider Details

I. General information

NPI: 1346069564
Provider Name (Legal Business Name): ASHLEY MERRILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 BLUE RIVER PKWY
SILVERTHORNE CO
80498-8958
US

IV. Provider business mailing address

PO BOX 1589
FRISCO CO
80443-1589
US

V. Phone/Fax

Practice location:
  • Phone: 720-600-7447
  • Fax:
Mailing address:
  • Phone: 810-599-2938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWC.0000001691
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: