=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548984461
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASHLEY WHIPKEY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2022
-----------------------------------------------------
Last Update Date | 10/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 119 E 2ND AVE
-----------------------------------------------------
City | FLANDREAU
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57028-1222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-360-2994
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 12TH AVE NW
-----------------------------------------------------
City | PIPESTONE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56164-1356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-360-2994
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ASHLEY WHIPKEY
-----------------------------------------------------
Credential | LICSW
-----------------------------------------------------
Telephone | 605-360-2994
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------