Provider Demographics
NPI:1679086102
Name:ASHENFELTER, BRIAN ERIC (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ERIC
Last Name:ASHENFELTER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 SILVERSIDE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1768
Mailing Address - Country:US
Mailing Address - Phone:302-798-7464
Mailing Address - Fax:
Practice Address - Street 1:405 SILVERSIDE RD STE 204
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1768
Practice Address - Country:US
Practice Address - Phone:302-798-7464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018723103TB0200X
DEB1-0001180103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty