Provider Demographics
NPI:1124469192
Name:YANCHO, ASHLEY KATE (LMSW, CAADC, MPA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KATE
Last Name:YANCHO
Suffix:
Gender:F
Credentials:LMSW, CAADC, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 BROOKHOLLOW DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9223
Mailing Address - Country:US
Mailing Address - Phone:586-747-8204
Mailing Address - Fax:
Practice Address - Street 1:1845 RW BERENDS DR SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-4955
Practice Address - Country:US
Practice Address - Phone:616-303-3917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010948591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical