Provider Demographics
NPI:1831761394
Name:THOMAS, ASHLEY (LLPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:412 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1626
Mailing Address - Country:US
Mailing Address - Phone:248-894-0824
Mailing Address - Fax:
Practice Address - Street 1:104 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-2101
Practice Address - Country:US
Practice Address - Phone:810-373-9062
Practice Address - Fax:810-484-0027
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional