Provider Demographics
NPI:1629275292
Name:ASHLEY, ERICA RENEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:RENEE
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:R
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1310 N HEARNE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-6516
Mailing Address - Country:US
Mailing Address - Phone:318-676-5643
Mailing Address - Fax:318-676-5944
Practice Address - Street 1:1310 N HEARNE AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-6516
Practice Address - Country:US
Practice Address - Phone:318-676-5111
Practice Address - Fax:318-676-5944
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6805OtherLPC LICENSE