Provider Demographics
NPI:1265824676
Name:GEORGE, ASHLEY (MHC-LP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HOMECREST CT
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2209
Mailing Address - Country:US
Mailing Address - Phone:516-766-6283
Mailing Address - Fax:
Practice Address - Street 1:71 HOMECREST CT
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2209
Practice Address - Country:US
Practice Address - Phone:516-766-6283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-22
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP96098101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)