Provider Demographics
NPI:1700242799
Name:PILLARD, ASHLEY (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PILLARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-1309
Mailing Address - Country:US
Mailing Address - Phone:817-307-1968
Mailing Address - Fax:469-217-1245
Practice Address - Street 1:5820 COUNTY ROAD 206
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:TX
Practice Address - Zip Code:76050-3229
Practice Address - Country:US
Practice Address - Phone:469-454-8727
Practice Address - Fax:469-217-1245
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71405101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX362434802Medicaid
TX362434801Medicaid