Provider Demographics
NPI:1942813092
Name:DILLARD, ASHLEY RENEE (LCPC, LMHC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:DILLARD
Suffix:
Gender:F
Credentials:LCPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 KIMBERLY RD STE 265S
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3582
Mailing Address - Country:US
Mailing Address - Phone:563-293-5772
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 265S
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3582
Practice Address - Country:US
Practice Address - Phone:563-293-5772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2025-08-19
Deactivation Date:2024-06-10
Deactivation Code:
Reactivation Date:2024-06-28
Provider Licenses
StateLicense IDTaxonomies
IL180015475101YP2500X, 101YP2500X
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health