=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528976529
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY MANCHESTER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2026
-----------------------------------------------------
Last Update Date | 08/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4815 S 107TH AVE
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68127-1904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-455-0808
-----------------------------------------------------
Fax | 402-881-8668
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17752 PIERCE CT APT W209
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68130-1342
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-455-0808
-----------------------------------------------------
Fax | 402-881-8668
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 15064
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------