Provider Demographics
NPI:1609225267
Name:HERRERA, ASHTON T (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:T
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:ASHTON
Other - Middle Name:T
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:821 W PERSHING BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-2537
Mailing Address - Country:US
Mailing Address - Phone:307-214-4012
Mailing Address - Fax:
Practice Address - Street 1:3608 CAMPFIRE TRL
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-7519
Practice Address - Country:US
Practice Address - Phone:307-214-4012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-05
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1860101YP2500X
WYPPC-1058101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator