Healthcare Provider Details

I. General information

NPI: 1225546807
Provider Name (Legal Business Name): ASHLEY HARROLLE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY WINFREE

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 23RD ST S STE 102
BIRMINGHAM AL
35205-2462
US

IV. Provider business mailing address

1034 23RD ST S STE 102
BIRMINGHAM AL
35205-2462
US

V. Phone/Fax

Practice location:
  • Phone: 205-606-7632
  • Fax:
Mailing address:
  • Phone: 205-607-7632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4202
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: