Healthcare Provider Details

I. General information

NPI: 1124684238
Provider Name (Legal Business Name): BROOKE ASHLEY COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 CENTER ST
CLIO MI
48420-1148
US

IV. Provider business mailing address

740 CENTER ST
CLIO MI
48420-1148
US

V. Phone/Fax

Practice location:
  • Phone: 810-686-7313
  • Fax: 810-686-7315
Mailing address:
  • Phone: 810-686-7313
  • Fax: 810-686-7315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. BROOKE J ASHLEY
Title or Position: PROPRIETOR
Credential: LMSW
Phone: 810-845-4741