MEDICARE: ASHLEY LYNCH GAEDE 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	101YM0800X	Mental Health Counselor	LPC-18879	AZ

General Provider Information

NPI Number	:	1760911473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LYNCH GAEDE LPC

Provider Business Mailing Address
First Line	:	43458 N MURPHY AVE
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-9822
Country	:	US
Telephone Number	:	480-788-9676
Fax Number	:

Provider Business Practice Location Address
First Line	:	43458 N MURPHY AVE
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-9822
Country	:	US
Telephone Number	:	480-788-9676
Fax Number	:

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

Provider Enumeration Date	:	06/06/2017
Last Update Date	:	12/30/2025

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