Provider Demographics
NPI:1992943443
Name:ASHLEY, LAWRENCE H (CASAC)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:H
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 BOWLING LN
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-6724
Mailing Address - Country:US
Mailing Address - Phone:631-242-0029
Mailing Address - Fax:
Practice Address - Street 1:401 STATE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1706
Practice Address - Country:US
Practice Address - Phone:718-625-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7502101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)