Provider Demographics
NPI:1932895117
Name:SMITH, ASHLEY NICOLE (TBS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:TBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1411
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-564-9296
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1411
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:330-564-9296
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHC2507375101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator