Individual provider Active NPI

Ashley Nicole Koontz, LPC

  • Professional Counselor
  • Charleston, WV
National Provider Identifier
1164387494
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3149 Issued in WV
Practice address
511 Morris St
Charleston, WV 25301-1326
Phone
(304) 341-0511
NPI assigned
Dec 18, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3149 WV Primary

Addresses

Primary practice location

511 Morris St
Charleston, WV 25301-1326

Mailing address

511 Morris St
Charleston, WV 25301-1326
Phone (304) 341-0511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260131000584 WV Practitioner - Mental Health Counselor 7911485925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

99 Swarthmore Ave
Charleston, WV 25302-3211

PO Box
Suite 16309
Jacksonville, FL 32245

PO Box
Suite 3466
Charleston, WV 25334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3149WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prestera Center for Mental Health Services Inc CurrentSince Jan 1, 2026 Accepting new patients
Prestera Center for Mental Health Services Inc CurrentSince Jan 1, 2026 Accepting new patients

Locations

99 Cracker Barrel Dr
Ste 100
Barboursville, WV 25504
Phone 30452578512514

511 Morris St
Charleston, WV 25301
Phone (304) 341-0511

376 Kenmore Dr
Danville, WV 25053
Phone (304) 369-1930

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1164387494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-341-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-341-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "3149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.