Mitich, Ashley Rae

Mitich, Ashley Rae is an sole proprietor health care provider with primary practice located at 15915 Crystal Creek Dr Suite C, Homer Glen IL 60491. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Mitich, Ashley Rae can be contacted via phone (708) 529-6976.

Contact Information

Primary practice address
15915 Crystal Creek Dr Suite C Homer Glen IL 60491
Phone: (708) 529-6976
Fax: (708) 226-0010
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180.010649 Illinois
Behavioral Health & Social Service Providers / Counselor 101Y00000X 178.006788 Illinois
Behavioral Health & Social Service Providers / Professional 101YP2500X 180.010649 Illinois

Profile Details

NPI number 1932414026
LBN Legal business name Mitich, Ashley Rae
Credentials EDD, LCPC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2010
Last updated Aug 27th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932414026 NPPES
Illinois Other 1622805 BCBS PROVIDER NUMBER

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