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General NPI Number Information
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NPI Number | 1336729557
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE MESEY LCPC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 950 4TH ST
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City | CARROLLTON
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State | IL
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Zip | 62016-1513
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Country | US
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Telephone | 217-370-5837
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Fax |
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Provider Business Mailing Address
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Address Line | 320 S LOCUST ST
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City | CARLINVILLE
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State | IL
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Zip | 62626-1648
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Country | US
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Telephone | 217-854-3166
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Fax | 217-854-3778
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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 | 180.016627
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License Number State | IL
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