Provider Demographics
NPI:1023604386
Name:OSBORNE, ASHLEY S (LLPC)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:S
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-0210
Mailing Address - Country:US
Mailing Address - Phone:989-999-8463
Mailing Address - Fax:989-266-1440
Practice Address - Street 1:8702 WANDERING WAY
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-9557
Practice Address - Country:US
Practice Address - Phone:989-999-8463
Practice Address - Fax:989-266-1440
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024097101YM0800X, 101YP2500X
374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6451024097OtherLLPC