Healthcare Provider Details

I. General information

NPI: 1932872702
Provider Name (Legal Business Name): ASHLEE AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 MEADOWBROOK AVE SE
WARREN OH
44483-6331
US

IV. Provider business mailing address

434 MEADOWBROOK AVE SE
WARREN OH
44483-6331
US

V. Phone/Fax

Practice location:
  • Phone: 234-430-9753
  • Fax:
Mailing address:
  • Phone: 234-430-9753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2304759-TRNE
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: