MEDICARE: SARA ELIZABETH WILSON ASHBY LPCC

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	101YP2500X	Professional Counselor	164141	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487081592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELIZABETH WILSON ASHBY LPCC

Provider Business Mailing Address
First Line	:	1215 SOUTHTOWN BLVD STE 304
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-7407
Country	:	US
Telephone Number	:	270-423-6845
Fax Number	:	270-423-6699

Provider Business Practice Location Address
First Line	:	1215 SOUTHTOWN BLVD STE 304
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-7407
Country	:	US
Telephone Number	:	270-423-6845
Fax Number	:	270-423-6699

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

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	12/18/2025

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