Provider Demographics
NPI:1699308981
Name:GAINES, ASHLEY JANE (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JANE
Last Name:GAINES
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 1:101 QUIGLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17240-9372
Mailing Address - Country:US
Mailing Address - Phone:717-404-5011
Mailing Address - Fax:
Practice Address - Street 1:600 MILLER ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1064
Practice Address - Country:US
Practice Address - Phone:717-264-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional