SHELLEY BOEHM MATTIA (NPI# 1073662938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073662938 |
| Entity Type | Individual |
| Full Name | SHELLEY BOEHM MATTIA |
| Credential | M.D. |
| Practice Address |
428 Doty Street Green Bay WI 54301 |
| Mailing Address |
Po Box 1012 Green Bay WI 54305-1012 |
| Practice Telephone | 9209656768 |
| Practice Fax Number | 9209656769 |
| Mailing Telephone | 9209656768 |
| Mailing Fax Number | 9209656769 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2016-11-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
39641 | WI | Allopathic & Osteopathic Physicians |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BB4448331 | 01 |
| Street Address |
428 DOTY STREET |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083871503 | Anima Family Counseling, LLC | Psychiatry & Neurology | 2475 University Ave, Suite A, Green Bay, WI 54302-5099 | 2008-05-21 |
| 1386750115 | Peter M Fischer | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2006-08-22 |
| 1043295256 | George D Soncrant | Psychiatry & Neurology | 3000 Riverside Dr, Suite 180, Green Bay, WI 54301-1653 | 2005-12-09 |
| 1295226512 | Pyramid Psychiatric Care, LLC | Psychiatry & Neurology | 2475 University Ave Ste A, Green Bay, WI 54302-5099 | 2018-05-22 |
| 1861993172 | Sbh-green Bay, LLC | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2018-02-22 |
| 1629513973 | Verstehen, LLC | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2016-12-22 |
| 1922556778 | Sbh-green Bay, LLC | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311 | 2016-09-21 |
| 1033406038 | Emily R Rademacher | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2011-06-29 |
| 1457662249 | David M Mcmahon | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2010-06-25 |
| 1730406836 | Rekha Vijayan | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2010-04-28 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.