Provider Demographics
NPI:1992183677
Name:VALLICOTT, ASHLEY (LMHC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:VALLICOTT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 CONROY WINDERMERE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-2689
Mailing Address - Country:US
Mailing Address - Phone:407-522-9919
Mailing Address - Fax:407-522-9343
Practice Address - Street 1:7601 CONROY WINDERMERE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835
Practice Address - Country:US
Practice Address - Phone:407-522-9919
Practice Address - Fax:407-522-9343
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health