Healthcare Provider Details

I. General information

NPI: 1316851942
Provider Name (Legal Business Name): ASHLYN MASSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 NE RALPH POWELL RD STE C
LEES SUMMIT MO
64064-2372
US

IV. Provider business mailing address

25405 E ORIENT CEMETERY RD
HARRISONVILLE MO
64701-1693
US

V. Phone/Fax

Practice location:
  • Phone: 816-427-1337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2026047505
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: