Provider Demographics
NPI:1396243986
Name:KILGORE, ASHLEY A (MS, LPCC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:KILGORE
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 STREAMSIDE DR APT 63
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005-9262
Mailing Address - Country:US
Mailing Address - Phone:865-387-7762
Mailing Address - Fax:
Practice Address - Street 1:431 OHIO PIKE STE 189S
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3375
Practice Address - Country:US
Practice Address - Phone:513-770-1705
Practice Address - Fax:513-770-1705
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1800981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health