Healthcare Provider Details

I. General information

NPI: 1205130358
Provider Name (Legal Business Name): ANN GILE ANDERSON MS LMFT SAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N BLACKHAWK AVE
MADISON WI
53705-3357
US

IV. Provider business mailing address

6661 FLORANCE RUTH LN
SUN PRAIRIE WI
53590-9233
US

V. Phone/Fax

Practice location:
  • Phone: 608-238-9991
  • Fax:
Mailing address:
  • Phone: 608-214-7152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15368-130
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1422124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: