Provider Demographics
NPI:1124992508
Name:PROMES, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PROMES
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:NE
Mailing Address - Zip Code:68745-1743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:502 WAKEFIELD ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:NE
Practice Address - Zip Code:68745-1743
Practice Address - Country:US
Practice Address - Phone:402-256-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20240000877103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool