Individual provider Active NPI

Ashley Ann Tillery, LMFT

  • Marriage & Family Therapist
  • Whitewater, WI
National Provider Identifier
1619318979
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1170-124 Issued in WI
Practice address
1173 W Main St Ste B
Whitewater, WI 53190-1672
Phone
(262) 458-2525
Fax
(262) 458-2680
NPI assigned
Jul 15, 2013
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11800-120 WI
Marriage & Family Therapist 106H00000X 1170-124 WI Primary

Addresses

Primary practice location

1173 W Main St Ste B
Whitewater, WI 53190-1672

Mailing address

4229 W State Road 59
Edgerton, WI 53534-9418
Phone (715) 572-5362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11800-120WIMDSocial Worker
1170-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Influential Connections Counseling LLC Marriage & Family Therapist CurrentSince Aug 17, 2025 Accepting new patients
Marriage & Family Solutions, LLC PastSince Jun 6, 2019 Accepting new patients

Locations

1173 W Main St
Ste B
Whitewater, WI 53190
Phone (262) 207-4197

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1619318979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 W STATE ROAD 59",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349418",
            "telephone_number": "715-572-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 W MAIN ST STE B",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901672",
            "telephone_number": "262-458-2525",
            "fax_number": "262-458-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "ASHLEY",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "11800-120",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1170-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitewater, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.