Provider Demographics
NPI:1760998579
Name:ASHLEY, LAUREN (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38066-1505
Mailing Address - Country:US
Mailing Address - Phone:901-647-0540
Mailing Address - Fax:
Practice Address - Street 1:30 MALLARD LN
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38066-1505
Practice Address - Country:US
Practice Address - Phone:901-647-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3661101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health