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Individual

GREGORY PAUL ULLSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L..P..C.

Contact information

Practice address
122 W WASHINGTON AVE, MADISON, WI 53703-2718
(262) 999-3495
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(262) 999-3495

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19509-130
WI
101YP2500X
Professional Counselor
Primary
11073-125
WI
101YP2500X
Professional Counselor
7001-226
WI

Other

Enumeration date
06/02/2022
Last updated
08/12/2025
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