Provider Demographics
NPI:1558630525
Name:YOUNG, ASHLEE NICOLE CROUSE (MS, LCPC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEE
Middle Name:NICOLE CROUSE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 PRESERVATION CIR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-0685
Mailing Address - Country:US
Mailing Address - Phone:410-591-6535
Mailing Address - Fax:
Practice Address - Street 1:1840 PRESERVATION CIR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809
Practice Address - Country:US
Practice Address - Phone:410-591-6535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GALPC011048101YP2500X
MDLC5482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health