Individual
MR. JAY WILLIAM GAETHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, SAC, CSW
Contact information
Practice address
500 ELM GROVE RD, SUITE 100, ELM GROVE, WI 53122-2546
(262) 782-2090
(262) 782-2092
Mailing address
500 ELM GROVE RD, SUITE 100, ELM GROVE, WI 53122-2546
(262) 782-2090
(262) 782-2092
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
3912
WI
Other
Enumeration date
10/26/2006
Last updated
05/14/2024
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