Healthcare Provider Details

I. General information

NPI: 1164741625
Provider Name (Legal Business Name): ASHLEY L LAYRISSON MA, LPCC, LCDCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 504
TOLEDO OH
43606-1356
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 504
TOLEDO OH
43606-1356
US

V. Phone/Fax

Practice location:
  • Phone: 419-318-8533
  • Fax:
Mailing address:
  • Phone: 419-318-8533
  • Fax: 888-337-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0600555-S
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberE.0600555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: