Healthcare Provider Details

I. General information

NPI: 1023940863
Provider Name (Legal Business Name): ASHLEY VOID PH.D. LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6309 LIBERIA ST
CAPITOL HEIGHTS MD
20743-1868
US

IV. Provider business mailing address

6309 LIBERIA ST
CAPITOL HEIGHTS MD
20743-1868
US

V. Phone/Fax

Practice location:
  • Phone: 202-297-4444
  • Fax: 202-297-4444
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP16530
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: