Healthcare Provider Details

I. General information

NPI: 1336604487
Provider Name (Legal Business Name): ASHLEY C UMLAUF MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2019
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5534 SAINT JOE RD
FORT WAYNE IN
46835-3328
US

IV. Provider business mailing address

432 S BROAD ST
GRIFFITH IN
46319-3133
US

V. Phone/Fax

Practice location:
  • Phone: 317-721-1175
  • Fax:
Mailing address:
  • Phone: 317-721-1175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35002106A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: