Provider Demographics
NPI:1164030946
Name:HACKETT, ASHLEY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:HACKETT
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 1:6876 LAUREL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1619
Mailing Address - Country:US
Mailing Address - Phone:404-844-9411
Mailing Address - Fax:
Practice Address - Street 1:6876 LAUREL RIDGE CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1619
Practice Address - Country:US
Practice Address - Phone:404-844-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health