Provider Demographics
NPI:1669867891
Name:WAITHE, ASHLEY (LMHC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WAITHE
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 1:12004 NW 164TH TER
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-6459
Mailing Address - Country:US
Mailing Address - Phone:386-972-2499
Mailing Address - Fax:
Practice Address - Street 1:101 NW 75TH ST STE 1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6665
Practice Address - Country:US
Practice Address - Phone:352-922-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health