Healthcare Provider Details

I. General information

NPI: 1548180896
Provider Name (Legal Business Name): ASHLEY GUILLORY LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 REYNOLDA RD
WINSTON SALEM NC
27104-3245
US

IV. Provider business mailing address

1001 REYNOLDA RD
WINSTON SALEM NC
27104-3245
US

V. Phone/Fax

Practice location:
  • Phone: 336-721-7600
  • Fax: 336-728-4355
Mailing address:
  • Phone: 336-721-7600
  • Fax: 336-728-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number767054
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23165
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: