Provider Demographics
NPI:1801136304
Name:BUFFINGTON, ASHLEY TAYLOR (LPC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:TAYLOR
Last Name:BUFFINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1640 POWERS FERRY RD. BUILDING 6 STE. 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:404-762-9190
Mailing Address - Fax:404-762-9101
Practice Address - Street 1:1640 POWERS FERRY RD BUILDING 6 STE. 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:678-813-2408
Practice Address - Fax:678-888-3708
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC #007628101YP2500X
101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health