Active NPI
Michelle Jetzer
- School Psychologist
- Milwaukee, WI
National Provider Identifier
1396652293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 3590000789
- Practice address
- 3666 S Clement Ave
Milwaukee, WI 53207-3566 - Phone
- (414) 294-1500
- NPI assigned
- Aug 26, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 3590000789 | WI | Primary |
Addresses
Primary practice location
3666 S Clement Ave
Milwaukee, WI 53207-3566
Mailing address
3666 S Clement Ave
Milwaukee, WI 53207-3566
Phone (414) 294-1588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1396652293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3666 S CLEMENT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532073566",
"telephone_number": "414-294-1588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3666 S CLEMENT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532073566",
"telephone_number": "414-294-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JETZER",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-08-26",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WI",
"license": "3590000789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.