Healthcare Provider Details

I. General information

NPI: 1396268181
Provider Name (Legal Business Name): ALLISON ORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 REGENT ST
MADISON WI
53715-2634
US

IV. Provider business mailing address

1619 MOCCASIN TRL
WAUKESHA WI
53189-6872
US

V. Phone/Fax

Practice location:
  • Phone: 262-951-8914
  • Fax:
Mailing address:
  • Phone: 262-951-8914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1390-124
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3444
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.001596
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: