Healthcare Provider Details

I. General information

NPI: 1407225204
Provider Name (Legal Business Name): ASHLEY C HANCOCK LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 6TH AVE S STE 305
SAINT PETERSBURG FL
33701-4664
US

IV. Provider business mailing address

701 94TH AVE N # 250
SAINT PETERSBURG FL
33702-2448
US

V. Phone/Fax

Practice location:
  • Phone: 727-321-3854
  • Fax: 727-327-7670
Mailing address:
  • Phone: 727-321-3854
  • Fax: 727-327-7670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: