Provider Demographics
NPI:1609538818
Name:HOLTSCLAW, MA, LPC, NCC, BC-TMH, ASHLEY J
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:HOLTSCLAW, MA, LPC, NCC, BC-TMH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-4833
Mailing Address - Country:US
Mailing Address - Phone:304-205-4117
Mailing Address - Fax:304-205-4118
Practice Address - Street 1:4626 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-4833
Practice Address - Country:US
Practice Address - Phone:304-205-4117
Practice Address - Fax:304-205-4118
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional