Provider Demographics
NPI:1114445111
Name:LAWSON, ASHLEY FORD (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:FORD
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24478 PRINCE EDWARD HWY
Mailing Address - Street 2:
Mailing Address - City:RICE
Mailing Address - State:VA
Mailing Address - Zip Code:23966-2798
Mailing Address - Country:US
Mailing Address - Phone:434-392-9276
Mailing Address - Fax:
Practice Address - Street 1:24478 PRINCE EDWARD HWY
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:VA
Practice Address - Zip Code:23966-2798
Practice Address - Country:US
Practice Address - Phone:434-392-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QC1500X, 261QD1600X, 320900000X
VA0701006691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1992092597Medicaid