Healthcare Provider Details

I. General information

NPI: 1215898549
Provider Name (Legal Business Name): WHITE ASH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7558 LONGMEADOW LN
ATHENS OH
45701-9473
US

IV. Provider business mailing address

7558 LONGMEADOW LN
ATHENS OH
45701-9473
US

V. Phone/Fax

Practice location:
  • Phone: 740-856-7496
  • Fax:
Mailing address:
  • Phone: 740-856-7496
  • Fax:

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: JENNIFER L. KOONS-WESTON
Title or Position: CLINICAL SOCIAL WORKER
Credential: LISW
Phone: 740-856-7496