Ashley Borum

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Modesto, CA

NPI 1154067189 · NPPES record last updated Mar 9, 2023

Key facts

NPI
1154067189
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
1235 McHenry Ave Ste a&B
Modesto, CA 95350-5370
Phone
(209) 527-4597
NPI assigned
May 11, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Treatment Centers, LLC Past
since May 16, 2022
Accepting new patients
Aegis Treatment Centers, LLC Past
since May 16, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

1235 McHenry Ave Ste a&B
Modesto, CA 95350-5370

Mailing address

2215 Tidewind Dr
Stockton, CA 95206-4968

Other providers in Modesto, CA

All providers in Modesto, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.