Healthcare Provider Details

I. General information

NPI: 1679086102
Provider Name (Legal Business Name): BRIAN ERIC ASHENFELTER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 SILVERSIDE RD STE 204
WILMINGTON DE
19809-1768
US

IV. Provider business mailing address

405 SILVERSIDE RD STE 204
WILMINGTON DE
19809-1768
US

V. Phone/Fax

Practice location:
  • Phone: 302-798-7464
  • Fax:
Mailing address:
  • Phone: 302-798-7464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS018723
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberB1-0001180
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: