Provider Demographics
NPI:1518406461
Name:JUSTER-KRUSE, ASHLEY LYNN (LMHC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:JUSTER-KRUSE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LYNN
Other - Last Name:GENTIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:930 CENTRAL AVENUE
Mailing Address - Street 2:UNIT 226
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705
Mailing Address - Country:US
Mailing Address - Phone:516-662-9955
Mailing Address - Fax:
Practice Address - Street 1:950 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3511
Practice Address - Country:US
Practice Address - Phone:516-822-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health