Provider Demographics
NPI:1891408662
Name:JOHNSON, ASHLLEY L (LMSW)
Entity type:Individual
Prefix:
First Name:ASHLLEY
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ASHLLEY
Other - Middle Name:L
Other - Last Name:HOUGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2825 S ANKENY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9417
Mailing Address - Country:US
Mailing Address - Phone:515-639-0506
Mailing Address - Fax:515-686-8003
Practice Address - Street 1:2825 S ANKENY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9417
Practice Address - Country:US
Practice Address - Phone:515-639-0506
Practice Address - Fax:515-686-8003
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker