Ashton Ezernack, LPC

Individual provider Active NPI Professional Counselor · Many, LA

NPI 1699059899 · NPPES record last updated Jan 2, 2013

Key facts

NPI
1699059899
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
265 Highland Drive
Many, LA 71449-3717
Phone
(318) 256-4119
Fax
(318) 256-4171
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

265 Highland Drive
Many, LA 71449-3717

Mailing address

265 Highland Drive
Many, LA 71449-3717
Phone (318) 256-4119

Other identifiers

IdentifierTypeStateIssuer
1710601MedicaidLA

Other providers in Many, LA

All providers in Many, LA · Professional Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.