Healthcare Provider Details

I. General information

NPI: 1083569370
Provider Name (Legal Business Name): ASHLEY N ZELLNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 GERSHWIN DR
GREEN BAY WI
54311-4328
US

IV. Provider business mailing address

2385 TALLADEGA SPEEDWAY
DE PERE WI
54115-8069
US

V. Phone/Fax

Practice location:
  • Phone: 920-391-4751
  • Fax:
Mailing address:
  • Phone: 920-857-4621
  • Fax: 920-857-4621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13209
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: