Ashley Starr Jackson

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Cliffwood, NJ

NPI 1417634841 · NPPES record last updated Jun 29, 2023

Key facts

NPI
1417634841
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
111 State Route 35
Cliffwood, NJ 07721-1512
Phone
(732) 812-5489
Fax
(732) 566-1937
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

111 State Route 35
Cliffwood, NJ 07721-1512

Mailing address

275 Laurence Pkwy # B
Laurence Harbor, NJ 08879-2766
Phone (908) 451-4120

Other names

  • Ashley Starr Mitricka Former name

Other providers in Cliffwood, NJ

All providers in Cliffwood, NJ · Addiction (Substance Use Disorder) Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.