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General NPI Number Information
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NPI Number | 1841683505
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Entity Type | Individual
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Provider Name | ASHLEY V EADDY LPC-I
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Gender | Female
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 1103 BELLEVIEW ST
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City | COLUMBIA
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State | SC
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Zip | 29201-1871
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Country | US
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Telephone | 803-606-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 4 WILD IRIS CT
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City | COLUMBIA
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State | SC
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Zip | 29209
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Country | US
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Telephone | 864-378-2613
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5744
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License Number State | SC
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