Provider Demographics
NPI:1386926558
Name:ASHLEY, TAMARA STEBLEZ (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:STEBLEZ
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:JOAN
Other - Last Name:STEBLEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:3050 FIVE FORKS TRICKUM RD SW
Mailing Address - Street 2:D545
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-1810
Mailing Address - Country:US
Mailing Address - Phone:678-458-7219
Mailing Address - Fax:404-869-6177
Practice Address - Street 1:15 LENOX POINTE NE
Practice Address - Street 2:SUITE B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-7415
Practice Address - Country:US
Practice Address - Phone:678-458-7219
Practice Address - Fax:404-869-6177
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007878101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional