MEDICARE: ASHLEY LEIGH EVERHART LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1568495737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LEIGH EVERHART LPC

Provider Business Mailing Address
First Line	:	141 MARSH RABBIT DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-8478
Country	:	US
Telephone Number	:	843-254-8585
Fax Number	:	843-215-4561

Provider Business Practice Location Address
First Line	:	9403 HIGHWAY 707
Second Line	:	SUITE B
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-7758
Country	:	US
Telephone Number	:	843-685-8716
Fax Number	:	843-215-4561

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/12/2011

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