Provider Demographics
NPI:1083219018
Name:CASSIDY, ASHLEY LYNETTE (MA, LPC, LAC)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:LYNETTE
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:MA, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18425 PONY EXPRESS DR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9605
Mailing Address - Country:US
Mailing Address - Phone:303-805-1218
Mailing Address - Fax:
Practice Address - Street 1:18425 PONY EXPRESS DR UNIT 203
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9605
Practice Address - Country:US
Practice Address - Phone:303-805-1218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017590101Y00000X
101YA0400X, 101YM0800X
COACD.0002155101YA0400X
COLPC.0019565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPCC.0017590OtherDORA