Provider Demographics
NPI:1396382768
Name:CLEVELAND, ASHLEY TAYLOR (LPC)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:TAYLOR
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:CLEVELAND
Other - Last Name:MADRID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:600 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8643
Mailing Address - Country:US
Mailing Address - Phone:256-975-4291
Mailing Address - Fax:
Practice Address - Street 1:1615 KATHY LN SW STE 102
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1026
Practice Address - Country:US
Practice Address - Phone:256-701-5651
Practice Address - Fax:256-429-9411
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8014101YP2500X
AL3770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional