Healthcare Provider Details

I. General information

NPI: 1609764562
Provider Name (Legal Business Name): ASHLEY MICHELLE WHITE PLMFT, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 E 70TH ST STE 110
SHREVEPORT LA
71105-5332
US

IV. Provider business mailing address

5374 LINTON CUTOFF RD
BENTON LA
71006-8774
US

V. Phone/Fax

Practice location:
  • Phone: 318-553-5591
  • Fax: 318-553-5592
Mailing address:
  • Phone: 318-771-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC10785
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberPLM1593
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: