Healthcare Provider Details

I. General information

NPI: 1023439395
Provider Name (Legal Business Name): ASHLEY N SCOTT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2014
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S EDWIN C MOSES BLVD
DAYTON OH
45417-3424
US

IV. Provider business mailing address

601 S EDWIN MOSES BLVD
DAYTON OH
45417-3424
US

V. Phone/Fax

Practice location:
  • Phone: 937-734-8333
  • Fax: 740-773-3985
Mailing address:
  • Phone: 937-734-8333
  • Fax: 740-775-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1300758
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1300758
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: