Provider Demographics
NPI:1669849287
Name:FREDERICK, ASHLEY (LPC-S)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:FREDERICK
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 WOOD DALE DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1111
Mailing Address - Country:US
Mailing Address - Phone:337-842-7489
Mailing Address - Fax:
Practice Address - Street 1:1525 LAKEVILLE DR STE 107
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2068
Practice Address - Country:US
Practice Address - Phone:832-640-9121
Practice Address - Fax:281-348-0819
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC6046101YP2500X
TXLPC#76761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional