Individual provider Active NPI

Jeffrey William Molter, PH.D.

  • Psychologist
  • Wausau, WI
National Provider Identifier
1326258633
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1874-057 Issued in WI
Practice address
630 S 36TH Ave
Wausau, WI 54401-3930
Phone
(715) 842-9500
Fax
(715) 848-0425
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1874-057 WI Primary

Addresses

Primary practice location

630 S 36TH Ave
Wausau, WI 54401-3930

Mailing address

630 S 36TH Ave
Wausau, WI 54401-3930
Phone (715) 842-9500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180912002472 WI Practitioner - Clinical Psychologist 6901156967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1874-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Clinic, LLC Psychologist CurrentSince Feb 16, 2026 Accepting new patients

Locations

2417 Post Rd
Stevens Point, WI 54481
Phone (715) 544-6144

630 S 36th Ave
Wausau, WI 54401
Phone (414) 301-1060

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1326258633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTER",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1874-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.