Provider Demographics
NPI:1942757406
Name:BATSIOS, ASHLEY (LMSW-C)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:BATSIOS
Suffix:
Gender:F
Credentials:LMSW-C
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:FULNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1640 WENWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-1150
Mailing Address - Country:US
Mailing Address - Phone:989-600-5134
Mailing Address - Fax:
Practice Address - Street 1:1402 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3705
Practice Address - Country:US
Practice Address - Phone:810-496-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1043554348Medicaid