Provider Demographics
NPI:1467072157
Name:WARREN, ASHLEY SHAUNTE (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHAUNTE
Last Name:WARREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:SHAUNTE
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASHLEY RICE
Mailing Address - Street 1:23621 SAGE VILLA DR
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-2075
Mailing Address - Country:US
Mailing Address - Phone:197-290-3216
Mailing Address - Fax:
Practice Address - Street 1:6021 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4040
Practice Address - Country:US
Practice Address - Phone:281-769-2238
Practice Address - Fax:281-769-2164
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7901101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7901Medicaid