Provider Demographics
NPI:1093094591
Name:PRATT, ASHLEIGH (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:PRATT
Suffix:
Gender:
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 FIR ST
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-1724
Mailing Address - Country:US
Mailing Address - Phone:508-560-4911
Mailing Address - Fax:
Practice Address - Street 1:808 FIR ST
Practice Address - Street 2:
Practice Address - City:T OR C
Practice Address - State:NM
Practice Address - Zip Code:87901-1724
Practice Address - Country:US
Practice Address - Phone:505-433-1427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1270041041C0700X
NM4025141041S0200X
NMSWB-2023-07641041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool