Healthcare Provider Details

I. General information

NPI: 1609367911
Provider Name (Legal Business Name): ASHLEY SWEET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 N COURT ST
WESTMINSTER MD
21157-5110
US

IV. Provider business mailing address

4623 FALLS RD
BALTIMORE MD
21209-4914
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-1233
  • Fax: 410-876-4791
Mailing address:
  • Phone: 410-366-1980
  • Fax: 410-366-8530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22277
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: