Healthcare Provider Details

I. General information

NPI: 1659825586
Provider Name (Legal Business Name): ASHLEY LAINE HOUCHIN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 S HIGHLAND AVE STE 200D
LOMBARD IL
60148-6174
US

IV. Provider business mailing address

1919 S HIGHLAND AVE STE 200D
LOMBARD IL
60148-6174
US

V. Phone/Fax

Practice location:
  • Phone: 708-566-6516
  • Fax: 331-472-1101
Mailing address:
  • Phone: 708-566-6516
  • Fax: 331-472-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP 2432
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number710009435
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.009435
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: