Provider Demographics
NPI:1295361541
Name:BEDEAU, ASHLEY ANALICIA (LCPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANALICIA
Last Name:BEDEAU
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 BRIGHTSEAT RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4736
Mailing Address - Country:US
Mailing Address - Phone:301-429-8950
Mailing Address - Fax:
Practice Address - Street 1:337 BRIGHTSEAT RD STE 210
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4736
Practice Address - Country:US
Practice Address - Phone:301-429-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9401101YM0800X
MDLC11394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health