Individual provider Active NPI

Ashley Jansen, MS, LPC-IT, SAC-IT

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1174287866
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
779929 Issued in WI
Practice address
202 S Park St
Madison, WI 53715-1507
Phone
(608) 417-6000
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 777602 WI
Professional Counselor 101YP2500X 779929 WI Primary

Addresses

Primary practice location

202 S Park St
Madison, WI 53715-1507

Mailing address

1015 Gammon LN
Madison, WI 53719-2210
Phone (608) 417-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250513002042 WI Practitioner - Mental Health Counselor 7810415957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
777602WIMDAddiction (Substance Use Disorder) Counselor
779929WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Meriter Hospital, Inc. CurrentSince Mar 8, 2025 Accepting new patients
Meriter Hospital, Inc. Current Accepting new patients

Locations

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

1015 Gammon Ln
Madison, WI 53719
Phone (608) 417-8144

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1174287866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 GAMMON LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192210",
            "telephone_number": "608-417-8144",
            "fax_number": "608-417-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151507",
            "telephone_number": "608-417-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "ASHLEY",
        "credential": "MS, LPC-IT, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "777602",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "779929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.