Organization Active NPI

Roslyn Ashford Wellness, Inc.

  • Mental Health Counselor
  • Laurel, MS
National Provider Identifier
1366064669
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ROSLYN ASHFORD WELLNESS, INC.
Practice address
409 W Oak St Ste 401D
Laurel, MS 39440-4169
Phone
(601) 228-1144
NPI assigned
May 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roslyn L Ashford, LPCNPI 1457817090
Title
Owner
Phone
(601) 307-3917

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

409 W Oak St Ste 401D
Laurel, MS 39440-4169

Mailing address

54 Mattie Dr
Ellisville, MS 39437-5147
Phone (601) 307-3917

Other names 1

  • Nu Leaf Therapy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://nuleaftherapy.secure-client-area.com/portal/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240723002414 MS Part B Supplier - Clinic/Group Practice 6406392794 Receives reassigned benefits from 2 practitioners
Practice locations: Ellisville, MS

National Provider Directory

National Provider Directory

Locations

409 W Oak St
Ste 401D
Laurel, MS 39440
Phone (601) 228-1144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1366064669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MATTIE DR",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394375147",
            "telephone_number": "601-307-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OAK ST STE 401D",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404169",
            "telephone_number": "601-228-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSLYN ASHFORD WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "ASHFORD",
        "authorized_official_first_name": "ROSLYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-307-3917",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://nuleaftherapy.secure-client-area.com/portal/",
            "affiliation": "N",
            "endpointDescription": "client portal",
            "address_1": "542 Central Ave",
            "city": "Laurel",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394403955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nu Leaf Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nu Leaf Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.