Healthcare Provider Details

I. General information

NPI: 1972410306
Provider Name (Legal Business Name): ASHTON JAMES HEBBE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

787 LOIS DR
SUN PRAIRIE WI
53590-1177
US

IV. Provider business mailing address

787 LOIS DR
SUN PRAIRIE WI
53590-1177
US

V. Phone/Fax

Practice location:
  • Phone: 920-588-8901
  • Fax:
Mailing address:
  • Phone: 920-588-8901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9266-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: