Healthcare Provider Details

I. General information

NPI: 1265361729
Provider Name (Legal Business Name): ASHLEY BANKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1249 S MAIN ST
LONDON KY
40741-2003
US

IV. Provider business mailing address

892 SPLIT POPLAR FORK RD
BOONEVILLE KY
41314-7078
US

V. Phone/Fax

Practice location:
  • Phone: 606-766-0880
  • Fax:
Mailing address:
  • Phone: 606-568-2306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number294859
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: