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

Jesse Frederick Peterson, PSYD

Individual provider Psychologist · NPI 1457996910

Jesse Frederick Peterson, PSYD is a Clinical Psychologist in Green Bay, Wisconsin. Qualified in 2017, 9 years ago. Practices with Bellin Memorial Hospital Inc, a 681-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2019
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone: (920) 433-6073
Fax: (920) 431-0333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 725 S Webster Ave, Green Bay, WI 54301-3500 — (920) 433-6073

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 3690-57 (WI)

Record details

NPI number1457996910
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedNovember 8, 2019
Last updated in NPPESNovember 11, 2019
Mailing addressPo Box 22040, Green Bay, WI 54305-2040

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Bellin Memorial Hospital Inc — 681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Green Bay