Provider Demographics
NPI:1982205191
Name:BIXBY, ASHLEE TOLLE (MED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:TOLLE
Last Name:BIXBY
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 MERRILL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-6205
Mailing Address - Country:US
Mailing Address - Phone:832-483-9960
Mailing Address - Fax:
Practice Address - Street 1:373 1/2 W 19TH ST STE 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3946
Practice Address - Country:US
Practice Address - Phone:713-574-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76715101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty