Provider Demographics
NPI:1205130358
Name:ANDERSON, ANN GILE (MS LMFT SAC)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:GILE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS LMFT SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6661 FLORANCE RUTH LN
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9233
Mailing Address - Country:US
Mailing Address - Phone:608-214-7152
Mailing Address - Fax:
Practice Address - Street 1:702 N BLACKHAWK AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3357
Practice Address - Country:US
Practice Address - Phone:608-238-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1422124101YM0800X
WI15368-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1422124OtherLMFT
WI15368-130OtherSUBSTANCE ABUSE COUNSELOR