ASHLEY CAROL GOLLY (LMHC) – Mental Health Counselor, NPI 1114352481
Mental Health Counselor
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
630 MENTAL HEALTH COUNSELOR in IA
Provider Addresses for ASHLEY CAROL GOLLY (LMHC)
621 S ILLINOIS AVE STE 103
MASON CITY, IA 504015489
Phone: (641) 428-3041
Fax: (641) 428-3059
Type: Mailing
1316 S MAIN ST
CLARION, IA 505252019
Phone: (515) 602-9833
Fax: (319) 343-1161
Type: Mailing
700 2ND ST SE STE 101
HAMPTON, IA 504412658
Phone: (641) 812-1094
Fax: (641) 812-1096
Type: Location
403 1st St SE
Belmond, IA 504211201
Phone: (641) 444-3500
Fax: (641) 444-5688
Type: Location
1000 4TH ST SW
MASON CITY, IA 504012800
Phone: (641) 428-7797
Fax: (641) 428-7516
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-11-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231129001019 | I | Mental Health Counselor | IA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 50401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OH | |
| General Surgery | IA | |
| Clinical Social Worker | IA | |
| Clinical Social Worker | IA | |
| Sleep Medicine, Internal Medicine | IA | |
| - | IA | |
| Emergency Medicine, Family Practice | NE | |
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IA |
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