Healthcare Provider Details

I. General information

NPI: 1104763945
Provider Name (Legal Business Name): ASHLEY MICHELLE KEMPKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FRANDORSON CIR STE 200
APOLLO BEACH FL
33572-2692
US

IV. Provider business mailing address

2089 BECKWITH AVE
SPRING HILL FL
34608-5809
US

V. Phone/Fax

Practice location:
  • Phone: 850-240-8744
  • Fax:
Mailing address:
  • Phone: 920-763-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: