Healthcare Provider Details

I. General information

NPI: 1376286609
Provider Name (Legal Business Name): LORI A ASHBAUGH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6N755 MURRAY RD
ST CHARLES IL
60175-6801
US

IV. Provider business mailing address

6N755 MURRAY RD
ST CHARLES IL
60175-6801
US

V. Phone/Fax

Practice location:
  • Phone: 815-409-5493
  • Fax:
Mailing address:
  • Phone: 815-409-5493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149027231
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: