Provider Demographics
NPI:1417832155
Name:VISCONTI, ASHTON LISA (LMHC)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:LISA
Last Name:VISCONTI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10675 CALLE MAR DE MARIPOSA APT 1416
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-8738
Mailing Address - Country:US
Mailing Address - Phone:607-222-3608
Mailing Address - Fax:
Practice Address - Street 1:10675 CALLE MAR DE MARIPOSA APT 1416
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-8738
Practice Address - Country:US
Practice Address - Phone:607-222-3608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health