Healthcare Provider Details

I. General information

NPI: 1891660197
Provider Name (Legal Business Name): ASHLY MCLEAN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 CASSIA ST
HERNDON VA
20170-2524
US

IV. Provider business mailing address

22611 MARKEY CT STE 114
STERLING VA
20166-6925
US

V. Phone/Fax

Practice location:
  • Phone: 571-568-9849
  • Fax: 571-486-5547
Mailing address:
  • Phone: 703-249-4828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024194969
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: