Healthcare Provider Details

I. General information

NPI: 1730415902
Provider Name (Legal Business Name): ANDREW JACOB VANHYFTE MA, SAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ANDREW JACOB VAN HYFT LPC

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 S PARK ST
MADISON WI
53715-1708
US

IV. Provider business mailing address

7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US

V. Phone/Fax

Practice location:
  • Phone: 608-282-8270
  • Fax:
Mailing address:
  • Phone: 608-282-8270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15519-131
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: