Provider Demographics
NPI:1154711091
Name:ASHLEY, MISTI DEAIRA (LPC)
Entity type:Individual
Prefix:MRS
First Name:MISTI
Middle Name:DEAIRA
Last Name:ASHLEY
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 1:401 E TOMBIGBEE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4716
Mailing Address - Country:US
Mailing Address - Phone:256-740-2082
Mailing Address - Fax:
Practice Address - Street 1:401 E TOMBIGBEE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4716
Practice Address - Country:US
Practice Address - Phone:256-740-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional