Healthcare Provider Details

I. General information

NPI: 1174994727
Provider Name (Legal Business Name): ASHLEY D CALLSTROM LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MAIN ST
NEWTON KS
67114-2200
US

IV. Provider business mailing address

4828 FARMSTEAD ST
BEL AIRE KS
67220-1642
US

V. Phone/Fax

Practice location:
  • Phone: 316-212-4602
  • Fax:
Mailing address:
  • Phone: 316-218-5637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9591
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06960
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: