Healthcare Provider Details

I. General information

NPI: 1487140307
Provider Name (Legal Business Name): ASHLEY JOHNSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY GOBEN

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 5TH ST STE 201
SAINT CHARLES MO
63301-1808
US

IV. Provider business mailing address

400 N 5TH ST STE 201
SAINT CHARLES MO
63301-1808
US

V. Phone/Fax

Practice location:
  • Phone: 636-202-1412
  • Fax:
Mailing address:
  • Phone: 636-202-1412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC1901846
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025032756
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: