Provider Demographics
NPI:1306314448
Name:STANCIU, ASHLEY JESSICA (LLMSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JESSICA
Last Name:STANCIU
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 HARTLAND DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5167
Mailing Address - Country:US
Mailing Address - Phone:248-635-2874
Mailing Address - Fax:
Practice Address - Street 1:35054 23 MILE RD STE 104
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-2019
Practice Address - Country:US
Practice Address - Phone:586-863-4000
Practice Address - Fax:586-863-4004
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011027811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical