Individual
JOHN GILANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CSAC, ICS
Contact information
Practice address
11512 N PORT WASHINGTON RD, MEQUON, WI 53092-3453
(262) 844-5758
Mailing address
2683 NORTHWOODS LN, PORT WASHINGTON, WI 53074-9785
(262) 844-5758
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2306-132
WI
1041C0700X
Clinical Social Worker
Primary
6672-123
WI
Other
Enumeration date
08/27/2012
Last updated
03/01/2020
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