MEDICARE: MISS ASHLEY MCCARTY

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1497100333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ASHLEY MCCARTY

Provider Business Mailing Address
First Line	:	1623 FOXHAVEN DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1623 FOXHAVEN DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1056
Country	:	US
Telephone Number	:	859-972-0045
Fax Number	:

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

Provider Enumeration Date	:	04/28/2016
Last Update Date	:	04/28/2016

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Directions to “ MISS ASHLEY MCCARTY ” Practice Location

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