Healthcare Provider Details

I. General information

NPI: 1982983961
Provider Name (Legal Business Name): ASHLEY NICOLE CARROLL-BROWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4757 W PARK BLVD STE 113
PLANO TX
75093-2329
US

IV. Provider business mailing address

4757 W PARK BLVD STE 113
PLANO TX
75093-2329
US

V. Phone/Fax

Practice location:
  • Phone: 469-443-8697
  • Fax:
Mailing address:
  • Phone: 469-443-8697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36788
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number13-10P
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: