Provider Demographics
NPI:1912694571
Name:IANNELLI, ASHLEIGH (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:IANNELLI
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 ELECTRIC RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3583
Mailing Address - Country:US
Mailing Address - Phone:540-344-5300
Mailing Address - Fax:
Practice Address - Street 1:2766 ELECTRIC RD STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3583
Practice Address - Country:US
Practice Address - Phone:540-344-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012388101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health