MEDICARE: MRS. ASHLEY SCHENK MILLER LPCA

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	A10109	NC

General Provider Information

NPI Number	:	1639412828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY SCHENK MILLER LPCA

Provider Business Mailing Address
First Line	:	1190 SMITHWOOD LN
Second Line	:
City	:	HICKORY GROVE
State	:	SC
Zip	:	29717-7790
Country	:	US
Telephone Number	:	803-417-0892
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 PEE DEE AVE
Second Line	:	SUITE A
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-4932
Country	:	US
Telephone Number	:	704-986-1561
Fax Number	:

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

Provider Enumeration Date	:	04/05/2013
Last Update Date	:	12/23/2013

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