Provider Demographics
NPI:1255781936
Name:ARD, LASHONDA L (LPC)
Entity type:Individual
Prefix:
First Name:LASHONDA
Middle Name:L
Last Name:ARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4780 I-55 N
Mailing Address - Street 2:STE 100-1025
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5583
Mailing Address - Country:US
Mailing Address - Phone:769-218-9054
Mailing Address - Fax:769-333-9157
Practice Address - Street 1:4780 I-55 N
Practice Address - Street 2:STE 100-1025
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5583
Practice Address - Country:US
Practice Address - Phone:769-218-9054
Practice Address - Fax:769-333-9157
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04159598Medicaid
MS004159598Medicaid