Provider Demographics
NPI:1285009159
Name:THOMPSON, ASHLEY E (LPCC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:E
Other - Last Name:WILLITS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:56520-1434
Mailing Address - Country:US
Mailing Address - Phone:218-643-9330
Mailing Address - Fax:218-641-1001
Practice Address - Street 1:115 5TH ST N
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:MN
Practice Address - Zip Code:56520-1434
Practice Address - Country:US
Practice Address - Phone:218-643-9330
Practice Address - Fax:218-641-1001
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1784101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor