Provider Demographics
NPI:1427565209
Name:ASHTON DALE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:ASHTON DALE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ASHTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CAC
Authorized Official - Phone:251-421-3550
Mailing Address - Street 1:20637 BLUEBERRY LN UNIT 26
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7279
Mailing Address - Country:US
Mailing Address - Phone:251-421-3550
Mailing Address - Fax:
Practice Address - Street 1:400 FAIRHOPE AVE STE 2A
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2126
Practice Address - Country:US
Practice Address - Phone:251-421-3550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1172101YA0400X
AL2106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty