Healthcare Provider Details

I. General information

NPI: 1760959852
Provider Name (Legal Business Name): ASHLEY RICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 LOGAN VALLEY RD
TRAVERSE CITY MI
49684-4772
US

IV. Provider business mailing address

3155 LOGAN VALLEY RD
TRAVERSE CITY MI
49684-4772
US

V. Phone/Fax

Practice location:
  • Phone: 402-677-9083
  • Fax: 231-216-7672
Mailing address:
  • Phone: 402-677-9083
  • Fax: 231-216-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801103481
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: