Provider Demographics
NPI:1053450486
Name:WILLIAMS-ASHMORE, JESSICA MAY (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MAY
Last Name:WILLIAMS-ASHMORE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W PORT ST
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-4040
Mailing Address - Country:US
Mailing Address - Phone:337-462-1641
Mailing Address - Fax:
Practice Address - Street 1:106 W PORT ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-4040
Practice Address - Country:US
Practice Address - Phone:337-462-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional