ASHLEY PRUITT
NPI 1194579078
Counselor in Springfield, IL

Active since April 16, 2024PECOS EnrolledAccepts Medicare Assignment
1630 S STATE ST, SPRINGFIELD, IL 62704(217) 528-3694 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ashley Pruitt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ASHLEY PRUITT (NPI 1194579078) is an individual counselor in Springfield, Illinois, licensed in Illinois (178018417) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1194579078
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameASHLEY PRUITT
Location Address1630 S STATE STSpringfield, IL 62704-3682
Mailing Address617 W Woodland AveSpringfield, IL 62704-2834
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 16, 2024
NPPES CertifiedApril 16, 2024
NPI 1194579078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License Licensed in IL · 178018417
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

1630 S STATE ST, Springfield, IL 62704

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ashley Pruitt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012408636
PECOS Enrollment IDI20251112000271
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Mental Health (Including Community Mental Health Center))
1630 S STATE ST
SPRINGFIELD, IL 62704
Counselor (Mental Health)
1630 S STATE ST
SPRINGFIELD, IL 62704
Counselor (Mental Health)
1630 S STATE ST
SPRINGFIELD, IL 62704
Clinic/Center (Mental Health (Including Community Mental Health Center))
1630 S STATE ST
SPRINGFIELD, IL 62704

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194579078, enumerated as an "individual" on April 16, 2024.

The provider is located at 1630 S STATE ST SPRINGFIELD, IL 62704 and the phone number is (217) 528-3694.

Counselor with taxonomy code 101Y00000X.