Healthcare Provider Details

I. General information

NPI: 1144467606
Provider Name (Legal Business Name): ASHLEY CALDWELL DEMERS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date: 03/04/2020
Reactivation Date: 05/06/2020

III. Provider practice location address

7842 PLANTATION RD
MACCLENNY FL
32063-5274
US

IV. Provider business mailing address

7842 PLANTATION RD
MACCLENNY FL
32063-5274
US

V. Phone/Fax

Practice location:
  • Phone: 802-318-7070
  • Fax:
Mailing address:
  • Phone: 802-318-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27620
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: