Provider Demographics
NPI:1043797673
Name:ASHLEY, SHELLY RANAE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:RANAE
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MOFFATT ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1217
Mailing Address - Country:US
Mailing Address - Phone:607-434-8185
Mailing Address - Fax:
Practice Address - Street 1:3 MOFFATT ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1217
Practice Address - Country:US
Practice Address - Phone:607-601-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102975101YM0800X
104100000X
NY093207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker