MEDICARE: ASHLEY STAGGARD LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37PC00740500	NJ

General Provider Information

NPI Number	:	1164923157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY STAGGARD LPC

Provider Business Mailing Address
First Line	:	1402 FRANCES DR
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-4414
Country	:	US
Telephone Number	:	732-492-8249
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 FRANCES DR
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-4414
Country	:	US
Telephone Number	:	732-492-8249
Fax Number	:	847-859-5885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2018
Last Update Date	:	02/27/2021

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Directions to “ ASHLEY STAGGARD LPC” Practice Location

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