Provider Demographics
NPI:1699310706
Name:ALBRIGHT, ASHLEY M (LCP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 COMMERCE ST STE B
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-5192
Mailing Address - Country:US
Mailing Address - Phone:208-634-2962
Mailing Address - Fax:
Practice Address - Street 1:1053 BANKS LOWMAN RD
Practice Address - Street 2:
Practice Address - City:GARDEN VALLEY
Practice Address - State:ID
Practice Address - Zip Code:83622-1003
Practice Address - Country:US
Practice Address - Phone:910-358-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-7523101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional