Healthcare Provider Details

I. General information

NPI: 1760782775
Provider Name (Legal Business Name): ASHLEY E WILSON LPC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY E FOULK LPC, LCPC

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 RIBAUT RD
BEAUFORT SC
29902-5435
US

IV. Provider business mailing address

775 RIBAUT RD
BEAUFORT SC
29902-5435
US

V. Phone/Fax

Practice location:
  • Phone: 202-329-6752
  • Fax:
Mailing address:
  • Phone: 202-329-6752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5265
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC3790
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: