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Individual

ASHLEY JANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC-IT, SAC-IT

Contact information

Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Mailing address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8144
(608) 417-8145

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
777602
WI
101YP2500X
Professional Counselor
Primary
779929
WI

Other

Enumeration date
10/28/2021
Last updated
10/28/2021
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