Provider Demographics
NPI:1720881196
Name:ASHLEY THIBOUTOT, LMHC,LLC
Entity type:Organization
Organization Name:ASHLEY THIBOUTOT, LMHC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THIBOUTOT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCPC
Authorized Official - Phone:508-925-0430
Mailing Address - Street 1:42 BUTTERWORTH RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364-9604
Mailing Address - Country:US
Mailing Address - Phone:508-925-0430
Mailing Address - Fax:774-389-1716
Practice Address - Street 1:42 BUTTERWORTH RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364-9604
Practice Address - Country:US
Practice Address - Phone:508-925-0430
Practice Address - Fax:774-389-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty