Healthcare Provider Details

I. General information

NPI: 1891621959
Provider Name (Legal Business Name): DYLAN RAY LEDFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 CHURCH ST UNIT 4
ASHEVILLE NC
28801-0112
US

IV. Provider business mailing address

133 CHURCH ST UNIT 4
ASHEVILLE NC
28801-0112
US

V. Phone/Fax

Practice location:
  • Phone: 828-407-0355
  • Fax:
Mailing address:
  • Phone: 828-407-0355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23077
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: