Provider Demographics
NPI:1962085969
Name:ELLIOTT, ASHLEY S (MS, LMHCA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:S
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:MS, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10685 TITAN DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8706
Mailing Address - Country:US
Mailing Address - Phone:812-499-4696
Mailing Address - Fax:
Practice Address - Street 1:10685 TITAN DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8706
Practice Address - Country:US
Practice Address - Phone:812-499-4696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
IN88000987A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral