Individual provider Active NPI

Ashley Ann Matthies, LPC

  • Professional Counselor
  • Menasha, WI
National Provider Identifier
1356190045
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11468-125 Issued in WI
Practice address
1476 Kenwood Dr
Ste 102
Menasha, WI 54952-1134
Phone
(920) 376-8920
NPI assigned
May 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11468-125 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16628-131 WI

Addresses

Primary practice location

1476 Kenwood Dr
Ste 102
Menasha, WI 54952-1134

Mailing address

W5820 Delta Dr
Menasha, WI 54952-4400
Phone (920) 851-5226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250206002379 WI Order and Referring Only - Mental Health Counselor 0941730808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16628-131WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Waves Counseling LLC Addiction (Substance Use Disorder) CurrentSince Jul 9, 2025 Accepting new patients

Locations

1476 Kenwood Dr
Ste 102
Menasha, WI 54952
Phone (920) 376-8920

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1356190045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5820 DELTA DR",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549524400",
            "telephone_number": "920-851-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1476 KENWOOD DR",
            "address_2": "STE 102",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521134",
            "telephone_number": "920-376-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHIES",
        "first_name": "ASHLEY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11468-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16628-131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.