Provider Demographics
NPI:1558190900
Name:KONERMANN, ASHLEY LYNN (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:KONERMANN
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 1:1505 CHAPARRAL RD
Mailing Address - Street 2:
Mailing Address - City:BURKBURNETT
Mailing Address - State:TX
Mailing Address - Zip Code:76354-2803
Mailing Address - Country:US
Mailing Address - Phone:940-235-2668
Mailing Address - Fax:
Practice Address - Street 1:1505 CHAPARRAL RD
Practice Address - Street 2:
Practice Address - City:BURKBURNETT
Practice Address - State:TX
Practice Address - Zip Code:76354-2803
Practice Address - Country:US
Practice Address - Phone:940-235-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health