Provider Demographics
NPI:1770237174
Name:STOLLMAN, ASHLEY CLAIRE (LMHC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CLAIRE
Last Name:STOLLMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:CLAIRE
Other - Last Name:YAGHOUBZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:158 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-2134
Mailing Address - Country:US
Mailing Address - Phone:631-872-3322
Mailing Address - Fax:
Practice Address - Street 1:158 FOREST ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-2134
Practice Address - Country:US
Practice Address - Phone:631-872-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.005287101YM0800X
NY010165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health