Provider Demographics
NPI:1437677275
Name:MAZZA, ASHLEY A (LPC, LICDC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:MAZZA
Suffix:
Gender:F
Credentials:LPC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1347
Mailing Address - Country:US
Mailing Address - Phone:740-578-4824
Mailing Address - Fax:740-578-4821
Practice Address - Street 1:254 PINECREST DR
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1347
Practice Address - Country:US
Practice Address - Phone:740-578-4824
Practice Address - Fax:740-578-4821
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH320981Medicaid