MEDICARE: DR. JANELLE WARNER ASHBY PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	20041285A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000388789	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154303238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANELLE WARNER ASHBY PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 414
Second Line	:
City	:	SHIPSHEWANA
State	:	IN
Zip	:	46565-0414
Country	:	US
Telephone Number	:	260-336-3362
Fax Number	:	260-768-7114

Provider Business Practice Location Address
First Line	:	245 N. MORTON
Second Line	:
City	:	SHIPSHEWANA
State	:	IN
Zip	:	46565
Country	:	US
Telephone Number	:	260-336-3362
Fax Number	:	260-768-7114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	03/19/2009

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