Provider Demographics
NPI:1871922955
Name:PARKS, ASHLEY (LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-1540
Mailing Address - Country:US
Mailing Address - Phone:704-680-7336
Mailing Address - Fax:
Practice Address - Street 1:1507 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-1540
Practice Address - Country:US
Practice Address - Phone:704-680-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional