Autumn Ashley Dekoster, LCPC, LMHP, CAADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.013574 Issued in IL

Practice address

1465 41St St Ste 6
Moline, IL 61265-2579

Phone

(309) 232-8669

Fax

(309) 326-4521

NPI assigned

Apr 23, 2019

Last updated

Sep 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Autumn Ashley Gonzalez Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pulse Counseling and Wellness Center PLLCGroup PAC ID 6608211354, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: autumn.gonzalez.p1@direct.tpqc.nextgenshare.com

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.

• Pulse Counseling & Wellness Center PLLC

  • Mental Health Counselor
  • Moline, IL
  • NPI 1245008754

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1699339978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 41ST ST STE 6",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652579",
            "telephone_number": "309-232-8669",
            "fax_number": "093-326-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 41ST ST STE 6",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652579",
            "telephone_number": "309-232-8669",
            "fax_number": "309-326-4521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 John Deere Rd",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612659951",
            "country_code": "US",
            "telephone_number": "309-762-5433",
            "fax_number": "309-762-4481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKOSTER",
        "first_name": "AUTUMN",
        "middle_name": "ASHLEY",
        "name_prefix": "Mrs.",
        "credential": "LCPC,  LMHP, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "36433",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.013574",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IA",
            "license": "108785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "GONZALEZ",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Moline, IL
• Providers in Moline, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.