Healthcare Provider Details

I. General information

NPI: 1598132417
Provider Name (Legal Business Name): ASHLEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COLONIAL CENTER PKWY STE 100N
ROSWELL GA
30076-4892
US

IV. Provider business mailing address

90 WINTER PARK LN
POWDER SPRINGS GA
30127-8600
US

V. Phone/Fax

Practice location:
  • Phone: 954-603-7885
  • Fax:
Mailing address:
  • Phone: 888-880-9270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015652
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: