Healthcare Provider Details

I. General information

NPI: 1275082133
Provider Name (Legal Business Name): HEATHER ASCHENBRENNER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HOWE BLVD
CANTON NY
13617-1125
US

IV. Provider business mailing address

1200 S BROAD ST
WINSTON SALEM NC
27101-5760
US

V. Phone/Fax

Practice location:
  • Phone: 315-229-8720
  • Fax:
Mailing address:
  • Phone: 336-722-8173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA12539
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: