MEDICARE: JOSEPH ANTHONY ASHLEY MSSA, LSW, CCTP-II

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1942847884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ANTHONY ASHLEY MSSA, LSW, CCTP-II

Provider Business Mailing Address
First Line	:	3805 WOODLAND AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2533
Country	:	US
Telephone Number	:	330-209-5331
Fax Number	:

Provider Business Practice Location Address
First Line	:	3805 WOODLAND AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2533
Country	:	US
Telephone Number	:	330-209-5331
Fax Number	:

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

Provider Enumeration Date	:	12/10/2019
Last Update Date	:	12/10/2019

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