Provider Demographics
NPI:1770137184
Name:WILMS, ASHLEY ECKLER (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ECKLER
Last Name:WILMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 S DELEON AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-7733
Mailing Address - Country:US
Mailing Address - Phone:321-482-8520
Mailing Address - Fax:
Practice Address - Street 1:1850 S DELEON AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-7733
Practice Address - Country:US
Practice Address - Phone:321-482-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health