Healthcare Provider Details

I. General information

NPI: 1598728776
Provider Name (Legal Business Name): BELLIN PSYCHIATRIC CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E SAINT JOSEPH ST
GREEN BAY WI
54301
US

IV. Provider business mailing address

301 E SAINT JOSEPH ST
GREEN BAY WI
54301-2241
US

V. Phone/Fax

Practice location:
  • Phone: 920-433-3630
  • Fax:
Mailing address:
  • Phone: 920-433-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DENISE K STROOBANTS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 920-445-7226