Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaime Gunderson, LCSW, CSAC

Individual provider Clinical Social Worker · NPI 1164955878

Jaime Gunderson, LCSW, CSAC is a Clinical Social Worker in Mayville, Wisconsin. Qualified in 2019, 7 years ago. Practices with Kettle Moraine Counseling LLC, a 20-clinician group. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2017
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

1446 Horicon St
Mayville, WI 53050-1467
Phone: (920) 539-0219
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 131568-121 (WI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 9826-123 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 16566-132 (WI)

Record details

NPI number1164955878
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , CSAC
Sole proprietorYes
NPI enumeratedApril 10, 2017
Last updated in NPPESOctober 23, 2022
Certification dateOctober 23, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Kettle Moraine Counseling Llc — 20 clinicians
Accepts Medicare assignment Not indicated