Individual provider · Type 1 NPI
John Thomas Kettler, CSAC, LPC-IT
Addiction (Substance Use Disorder) Counselor · Waukesha, WI
NPI number
1912236845
Active
Practice location
500 Riverview Ave
Waukesha, WI 53188-3632
Fax (262) 548-7656
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | 1016-226 (WI) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 15594-132 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1912236845
John Thomas Kettler, CSAC, LPC-IT's National Provider Identifier is 1912236845, issued on Dec 24, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Waukesha, WI. The record was last updated on Oct 20, 2011.