Healthcare Provider Details

I. General information

NPI: 1629685151
Provider Name (Legal Business Name): NICOLE ASH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICOLE HILTNER

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6549 TOWN CENTER DR
CLARKSTON MI
48346-4824
US

IV. Provider business mailing address

6549 TOWN CENTER DR
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 800-395-3223
  • Fax:
Mailing address:
  • Phone: 800-395-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401225239
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: