Provider Demographics
NPI:1942032545
Name:KOEPNICK, ASHLEY S (MS, PLPC, NCC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
Last Name:KOEPNICK
Suffix:
Gender:F
Credentials:MS, PLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 YOUREE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2121
Mailing Address - Country:US
Mailing Address - Phone:318-615-9006
Mailing Address - Fax:318-302-2153
Practice Address - Street 1:3605 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2121
Practice Address - Country:US
Practice Address - Phone:318-615-9006
Practice Address - Fax:318-302-2153
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC9582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health