Individual provider Active NPI

Ashley McMurtry

  • Professional Counselor
  • Peoria, IL
National Provider Identifier
1982325866
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.018338 Issued in IL
Practice address
719 W Lake Ave
Peoria, IL 61614-5941
Phone
(309) 408-1493
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 178.018338 IL Primary

Addresses

Primary practice location

719 W Lake Ave
Peoria, IL 61614-5941

Mailing address

719 W Lake Ave
Peoria, IL 61614-5941

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240221003385 IL Practitioner - Mental Health Counselor 0446603344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edge Counseling and Wellness LLCGroup PAC ID 1951659465, 8 clinicians

Practice addresses (Care Compare)

5101 N Executive Dr
Peoria, IL 61614-4868
Phone (309) 408-1493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.018338ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edge Counseling and Wellness LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

719 W Lake Ave
Peoria, IL 61614
Phone (309) 408-1493

5101 N Executive Dr
Peoria, IL 61614
Phone (309) 408-1493

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1982325866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145941",
            "telephone_number": "309-408-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURTRY",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-06-06",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.