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

Mr. Jay William Gaethke, LPC, SAC, CSW

Individual provider Mental Health Counselor · NPI 1346325446

Mr. Jay William Gaethke, LPC, SAC, CSW is a Mental Health Counselor in Elm Grove, Wisconsin. Qualified in 2002, 24 years ago. Practices with Prohealth Medical Group Inc, a 472-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
24
Licensed in
WI
In the registry since
2006
Specialties on file
3
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

500 Elm Grove Rd Ste 100
Elm Grove, WI 53122-2546
Phone: (262) 782-2090
Fax: (262) 782-2092
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 3912 (WI)
Mental Health Counselor Taxonomy 101YM0800X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1346325446
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC , SAC , CSW
Sole proprietorNo
NPI enumeratedOctober 26, 2006
Last updated in NPPESMay 14, 2024
Certification dateMay 14, 2024

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Prohealth Medical Group Inc — 472 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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