Provider Demographics
NPI:1578231718
Name:HALLETT, ASHLEY (LPCC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HALLETT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E FLYNN ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-2145
Mailing Address - Country:US
Mailing Address - Phone:507-696-4198
Mailing Address - Fax:
Practice Address - Street 1:14000 NORTHDALE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4662
Practice Address - Country:US
Practice Address - Phone:651-998-9619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2928101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health