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General NPI Number Information
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NPI Number | 1164351177
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Entity Type | Individual
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Provider Name | ASHLEY DAWN MOON LPCA
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Gender | Female
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 3055 MILLERSTOWN RD
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City | UPTON
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State | KY
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Zip | 42784-9432
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Country | US
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Telephone | 270-307-7841
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Fax |
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Provider Business Mailing Address
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Address Line | 3055 MILLERSTOWN RD
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City | UPTON
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State | KY
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Zip | 42784-9432
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 308608
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License Number State | KY
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