Individual provider Active NPI

Ashley E. Countryman, MS, LCPC, LCAC

  • Professional Counselor
  • Lawrence, KS
National Provider Identifier
1205103256
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
732 Issued in KS
Practice address
1629 E 24TH St
Lawrence, KS 66046-5338
Phone
(785) 312-4417
NPI assigned
Nov 18, 2011
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 121 KS
Professional Counselor 101YP2500X 732 KS Primary

Addresses

Primary practice location

1629 E 24TH St
Lawrence, KS 66046-5338

Mailing address

1629 E 24TH St
Lawrence, KS 66046-5338
Phone (785) 312-4417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20231211000433 KS Practitioner - Mental Health Counselor 4385093830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
732KSMDMental Health Counselor
121KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bert Nash Community Mental Health Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

200 Maine St
Ste A
Lawrence, KS 66044
Phone (785) 832-8192

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": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1205103256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 E 24TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660465338",
            "telephone_number": "785-312-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 E 24TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660465338",
            "telephone_number": "785-312-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUNTRYMAN",
        "first_name": "ASHLEY",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "MS, LCPC, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "121",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.