Provider Demographics
NPI:1841669157
Name:ASH, PAMELA (MS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:ASH
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 17TH ST STE W
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5687
Mailing Address - Country:US
Mailing Address - Phone:850-672-9071
Mailing Address - Fax:
Practice Address - Street 1:1456 OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3773
Practice Address - Country:US
Practice Address - Phone:772-564-8616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health