Provider Demographics
NPI:1356143853
Name:LONGABAUGH-CANTOS, ASHLEY (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:LONGABAUGH-CANTOS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 ALGONQUIN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-5905
Mailing Address - Country:US
Mailing Address - Phone:863-253-4320
Mailing Address - Fax:
Practice Address - Street 1:2721 ALGONQUIN AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-5905
Practice Address - Country:US
Practice Address - Phone:863-253-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25385101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health