Provider Demographics
NPI:1043578537
Name:WITHERS, ASHLEE (PLCAS)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEE
Middle Name:
Last Name:WITHERS
Suffix:
Gender:F
Credentials:PLCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ARBOR HILL PL
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9311
Mailing Address - Country:US
Mailing Address - Phone:336-638-0511
Mailing Address - Fax:
Practice Address - Street 1:42 ARBOR HILL PL
Practice Address - Street 2:
Practice Address - City:MC LEANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27301-9311
Practice Address - Country:US
Practice Address - Phone:336-638-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)