Healthcare Provider Details

I. General information

NPI: 1487328183
Provider Name (Legal Business Name): ASHLEY NICHOLE PRATT LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 7TH AVE S STE 202
ESCANABA MI
49829-1176
US

IV. Provider business mailing address

97 S 4TH ST STE C
ISHPEMING MI
49849-2168
US

V. Phone/Fax

Practice location:
  • Phone: 906-789-3528
  • Fax:
Mailing address:
  • Phone: 906-228-9699
  • Fax: 906-228-0505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851111307
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: