Provider Demographics
NPI:1912651100
Name:MILNER, ASHLEY W (LMSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:W
Last Name:MILNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:WENIFRED
Other - Last Name:DEWEES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:398 GLACIER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARIES
Mailing Address - State:ID
Mailing Address - Zip Code:83861-8793
Mailing Address - Country:US
Mailing Address - Phone:360-440-7301
Mailing Address - Fax:
Practice Address - Street 1:120 S 13TH ST
Practice Address - Street 2:
Practice Address - City:ST MARIES
Practice Address - State:ID
Practice Address - Zip Code:83861-1627
Practice Address - Country:US
Practice Address - Phone:208-245-4363
Practice Address - Fax:208-245-4349
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
ID41338104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional