Healthcare Provider Details

I. General information

NPI: 1407723216
Provider Name (Legal Business Name): MY ASHLEAH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S ROSELAWN AVE
ARTESIA NM
88210-2141
US

IV. Provider business mailing address

2411 W CENTRE AVE
ARTESIA NM
88210-2259
US

V. Phone/Fax

Practice location:
  • Phone: 575-308-3213
  • Fax:
Mailing address:
  • Phone: 575-308-3213
  • 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 Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK RICHARDS
Title or Position: PRESIDENT
Credential:
Phone: 575-308-3213