Individual
ASHELY JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
653 W ARRINGTON ST, FARMINGTON, NM 87401-8513
(505) 654-3733
Mailing address
653 W ARRINGTON ST, FARMINGTON, NM 87401-8513
(505) 654-3733
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CTB20240644
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
CTB20240644
—
104100000X
Social Worker
Primary
SWB20230059
NM
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/15/2020
Last updated
07/23/2025
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