Provider Demographics
NPI:1982445755
Name:KELLER, ASHLEY LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:KELLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-2474
Mailing Address - Country:US
Mailing Address - Phone:913-744-1926
Mailing Address - Fax:
Practice Address - Street 1:2922 N SPRING MEADOW CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1659
Practice Address - Country:US
Practice Address - Phone:316-250-5007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13619104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker