Provider Demographics
NPI:1255690780
Name:ANNE, ASHLEY (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:ANNE
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 N FARWELL AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2415
Mailing Address - Country:US
Mailing Address - Phone:920-591-2663
Mailing Address - Fax:
Practice Address - Street 1:3950 N FARWELL AVE APT 204
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-2415
Practice Address - Country:US
Practice Address - Phone:920-591-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health