Provider Demographics
NPI:1821764580
Name:KINGSTON, ASHLEY (MS, LCPC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:MS, LCPC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5449
Mailing Address - Country:US
Mailing Address - Phone:406-490-3868
Mailing Address - Fax:
Practice Address - Street 1:1864 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-5449
Practice Address - Country:US
Practice Address - Phone:406-490-3868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-50264101YP2500X
LA8856101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional