Healthcare Provider Details

I. General information

NPI: 1013368893
Provider Name (Legal Business Name): ASHLEY JUSTINE JACKSON DBH, LMFT, CCTP-II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY JUSTINE HUFFMAN DBH, LMFT, CCTP-II

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 WINTERHAM DR
ABINGDON VA
24211-3801
US

IV. Provider business mailing address

448 CUMMINGS ST STE 199
ABINGDON VA
24210-3220
US

V. Phone/Fax

Practice location:
  • Phone: 843-872-4422
  • Fax:
Mailing address:
  • Phone: 843-872-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: