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

Dr. Gary Glen Peterson, PHD

Individual provider Psychologist · NPI 1114130465

Dr. Gary Glen Peterson, PHD is a Psychologist in Ketchum, Idaho. Practices as a sole proprietor. Licensed in Arizona, California and Idaho.

Licensed in
AZ, CA, ID
In the registry since
2007
Specialties on file
3
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

675 Sun Valley Road C
Ketchum, ID 83340
Phone: (208) 928-6555
Fax: (208) 928-7666
Show map & directions

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

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence PSY 202479 (ID)
Psychologist Taxonomy 103T00000X · Licence 7790 (CA)
Psychologist Taxonomy 103T00000X · Licence 578 (AZ)

Record details

NPI number1114130465
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedMay 7, 2007
Last updated in NPPESAugust 5, 2010
Mailing addressPo Box 3441, Sun Valley, ID 83353-3441