Provider Demographics
NPI:1861068314
Name:GROVES, ASHLEY (CDCA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:GROVES
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FAYETTE CTR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-2120
Mailing Address - Country:US
Mailing Address - Phone:740-335-8228
Mailing Address - Fax:
Practice Address - Street 1:5 FAYETTE CTR
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-2120
Practice Address - Country:US
Practice Address - Phone:740-335-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH176990101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH176990OtherCHEMICAL DEPENDENCY ASSISTANT ID NUMBER