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NPI Code Detail

MEDICARE: ASHTEN WILKINSON LCDCIII

MEDICARE: ASHTEN WILKINSON LCDCIII
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorLCDCIII162965OH

General Provider Information

NPI Number : 1790564391
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHTEN WILKINSON LCDCIII
Provider Business Mailing Address
First Line : 20 ORANGE DR
Second Line :
City : WILLIAMSTOWN
State : WV
Zip : 26187-9771
Country : US
Telephone Number : 800-829-5461
Fax Number :
Provider Business Practice Location Address
First Line : 4977 NORTHCUTT PL
Second Line :
City : DAYTON
State : OH
Zip : 45414-3839
Country : US
Telephone Number : 800-829-5461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2023
Last Update Date : 02/03/2026

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