Ashlie Lynn Black, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R5804 Issued in OR

Practice address

1698 Liberty St SE
Salem, OR 97302-4348

Phone

(503) 884-5764

NPI assigned

Mar 24, 2017

Last updated

Jun 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Family Tree Relief Nursery

  • Voluntary or Charitable Agency
  • Albany, OR
  • NPI 1104375468
  NPD (past)

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1467983130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 WALLACE RD NW # A702",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043116",
            "telephone_number": "503-602-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024348",
            "telephone_number": "503-884-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ASHLIE",
        "middle_name": "LYNN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "R5804",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R5804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Bitikofer, LCSW
• Emma Elizabeth Bjorklund
• Erin E Bjorklund, N.P.
• Patricia Mary Bjorkquist, PH.D.
• Elizabeth Katherine Bjornskov, M.D.
• Sharla Black, BS, LMT
• Molly Margaret Blackburn, RDH
• Sheila Suzanne Blacketer, RDH
• Chelsea Blackett, MD
• Sadie J Blackhall, PA-C

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.