Provider Demographics
NPI:1902676661
Name:HORTON, ASHLEY (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-4807
Mailing Address - Country:US
Mailing Address - Phone:217-899-8767
Mailing Address - Fax:
Practice Address - Street 1:152 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-4807
Practice Address - Country:US
Practice Address - Phone:217-899-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178015944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health