Provider Demographics
NPI:1306273081
Name:VINK, ASHLEY (MA, LPC/I)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:VINK
Suffix:
Gender:F
Credentials:MA, LPC/I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665A HATTEN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-1503
Mailing Address - Country:US
Mailing Address - Phone:573-795-1462
Mailing Address - Fax:
Practice Address - Street 1:120 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:BATESBURG
Practice Address - State:SC
Practice Address - Zip Code:29006-2107
Practice Address - Country:US
Practice Address - Phone:803-532-8414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5619101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional