Provider Demographics
NPI:1457071599
Name:MACMUNN, ASHLEY NOLAN (LMHC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NOLAN
Last Name:MACMUNN
Suffix:
Gender:F
Credentials:LMHC, CRC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:RYAN
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6313 KEVESTA AVE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-2579
Mailing Address - Country:US
Mailing Address - Phone:941-201-9859
Mailing Address - Fax:
Practice Address - Street 1:6313 KEVESTA AVE
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-2579
Practice Address - Country:US
Practice Address - Phone:941-201-9859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health