Basic Information
| Provider Information | |||||||||
| NPI: | 1598787921 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASHBAUGH | ||||||||
| FirstName: | TANYA | ||||||||
| MiddleName: | ADAIR | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4640 BEMUS ELLERY RD | ||||||||
| Address2: | |||||||||
| City: | BEMUS POINT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147129417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163662122 | ||||||||
| FaxNumber: | 7163666455 | ||||||||
| Practice Location | |||||||||
| Address1: | 319 CENTRAL AVE STE B | ||||||||
| Address2: | |||||||||
| City: | DUNKIRK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140482137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163636050 | ||||||||
| FaxNumber: | 7163636851 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 12/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/18/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 066083-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.