Individual provider Active NPI

Ashley Marie Ertel, MSW

  • Clinical Social Worker
  • Dyess Afb, TX
National Provider Identifier
1285985838
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
697 Louisiana Rd
Dyess Afb, TX 79607-1141
Phone
(570) 688-5811
Fax
(325) 696-5380
NPI assigned
Sep 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5068 KY
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

697 Louisiana Rd
Dyess Afb, TX 79607-1141

Mailing address

697 Louisiana Rd
Dyess Afb, TX 79607-1141
Phone (570) 688-5811

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5068KYMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1285985838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 LOUISIANA RD",
            "city": "DYESS AFB",
            "state": "TX",
            "postal_code": "796071141",
            "telephone_number": "570-688-5811",
            "fax_number": "325-696-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 LOUISIANA RD",
            "city": "DYESS AFB",
            "state": "TX",
            "postal_code": "796071141",
            "telephone_number": "570-688-5811",
            "fax_number": "325-696-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTEL",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-23",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "5068",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyess Afb, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.