Healthcare Provider Details

I. General information

NPI: 1659725067
Provider Name (Legal Business Name): ASHLEY HARVIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16216 BAXTER RD STE 330
CHESTERFIELD MO
63017-4778
US

IV. Provider business mailing address

124 RUE GRAND DR
LAKE SAINT LOUIS MO
63367-1715
US

V. Phone/Fax

Practice location:
  • Phone: 573-321-5046
  • Fax:
Mailing address:
  • Phone: 757-570-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2020010475
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: