Provider Demographics
NPI:1942085295
Name:CUNDIFF, ASHLEIGH NICOLE (TCADC)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:NICOLE
Last Name:CUNDIFF
Suffix:
Gender:F
Credentials:TCADC
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:NICOLE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TCADC
Mailing Address - Street 1:864 BEAR TRACK RD APT 1
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-8711
Mailing Address - Country:US
Mailing Address - Phone:270-849-6188
Mailing Address - Fax:
Practice Address - Street 1:800 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1604
Practice Address - Country:US
Practice Address - Phone:270-849-6188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY276013101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor