Jesse F Kusserow, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7644125 Issued in WI

Practice address

2300 Riverside Dr
Green Bay, WI 54301-1900

Phone

(920) 541-6646

NPI assigned

Jan 29, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1033656079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 RIVERSIDE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011900",
            "telephone_number": "920-541-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RIVERSIDE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011900",
            "telephone_number": "920-541-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSSEROW",
        "first_name": "JESSE",
        "middle_name": "F",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-29",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7644125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandy J Kumpula, PHD
• Kayla Kuntz, LAT
• Jay J Kuritz, M.D.
• Tamara Mae Kurtz, BCBA
• Kathlene A Kusiv, D.O.
• Adam Ray Kuten, MD
• Russel J Kuzel, MD
• Katie Lynn Kyles, OD
• Dawn Marie La Luzerne, M.S., CCC-SLP
• La Sante Wisconsin Inc.

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.