Healthcare Provider Details

I. General information

NPI: 1194654095
Provider Name (Legal Business Name): ASHLEY SUSAN YUENGER LCSW, SAC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13850 W CAPITOL DR
BROOKFIELD WI
53005-2422
US

IV. Provider business mailing address

921 S 113TH ST
WEST ALLIS WI
53214-2215
US

V. Phone/Fax

Practice location:
  • Phone: 414-310-9948
  • Fax: 414-409-5150
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12779123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: