Healthcare Provider Details

I. General information

NPI: 1316879489
Provider Name (Legal Business Name): JANIS ASHBURN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4038 RIDGEVIEW DR STE 1
ANDERSON IN
46013-9715
US

IV. Provider business mailing address

697 PRO MED LN
CARMEL IN
46032-5323
US

V. Phone/Fax

Practice location:
  • Phone: 317-574-1254
  • Fax: 317-674-0060
Mailing address:
  • Phone: 317-574-1254
  • Fax: 317-574-1254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number39005997A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: