Provider Demographics
NPI:1639806300
Name:LAWSON, ASHANTA V (MASTERS LEVEL INTERN)
Entity type:Individual
Prefix:
First Name:ASHANTA
Middle Name:V
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MASTERS LEVEL INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12006 BIG SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8864
Mailing Address - Country:US
Mailing Address - Phone:561-317-6196
Mailing Address - Fax:
Practice Address - Street 1:2600 VILLAGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-3283
Practice Address - Country:US
Practice Address - Phone:945-444-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)