Provider Demographics
NPI:1861139636
Name:BRYANT, ASHLI (LPCC)
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 N EL CAMINO REAL STE 211
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5385
Mailing Address - Country:US
Mailing Address - Phone:909-735-3569
Mailing Address - Fax:
Practice Address - Street 1:285 N EL CAMINO REAL STE 211
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5385
Practice Address - Country:US
Practice Address - Phone:909-735-3569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11568101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health