Healthcare Provider Details

I. General information

NPI: 1548419567
Provider Name (Legal Business Name): AMY ROSE ASHTON-WILLIAMS LCSW, CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 NW 6TH ST
PENDLETON OR
97801-1501
US

IV. Provider business mailing address

115 NW 6TH ST
PENDLETON OR
97801-1501
US

V. Phone/Fax

Practice location:
  • Phone: 541-300-9994
  • Fax: 541-276-8605
Mailing address:
  • Phone: 541-300-9994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number07-09-56
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL5185
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: