Provider Demographics
NPI:1336733625
Name:PATRICK, ASHLEY JOY (LCMHC-A)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JOY
Last Name:PATRICK
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 E DIXON BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6893
Mailing Address - Country:US
Mailing Address - Phone:704-487-4000
Mailing Address - Fax:
Practice Address - Street 1:182 W COURT ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2805
Practice Address - Country:US
Practice Address - Phone:704-487-4000
Practice Address - Fax:704-487-4005
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health