DR. BRUCE J. ROBERTSON (NPI# 1396770434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396770434 |
| Entity Type | Individual |
| Full Name | DR. BRUCE J. ROBERTSON |
| Credential | PHD |
| Practice Address |
2631 Packerland Dr Suite 104-c Green Bay WI 54313-4130 |
| Practice Telephone | 9209657701 |
| Practice Fax Number | 9204974956 |
| Mailing Telephone | 9209657701 |
| Mailing Fax Number | 9204974956 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1992-057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39699400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871647016 | Bruce Douglas Robertson | Optometrist | 7903 W Grandridge Blvd # 1, Kennewick, WA 99336-7827 | 2007-01-23 |
| 1598756512 | Bruce D Robertson | Social Worker | 2512 Wheaton Way, Sutie B, Bremerton, WA 98310 | 2005-10-31 |
| 1689806903 | Bruce Allen Robertson | Counselor | 2027 Rose St, Sarasota, FL 34239-5223 | 2009-08-20 |
| 1649338476 | Bruce Robertson | Physician Assistant | 36000 Darnall Loop, Carl R Darnall Army Medical Center, Fort Hood, TX 76544-5095 | 2006-12-05 |
| 1003875923 | Bruce A Robertson | Family Medicine | 13851 E 14th St, Suite 102, San Leandro, CA 94578-2628 | 2006-03-20 |
| Street Address |
2631 PACKERLAND DR SUITE 104-C |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54313-4130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942245493 | Gail J Krawczyk | Social Worker | 2631 Packerland Dr, Suite 104c, Green Bay, WI 54313-4130 | 2006-06-18 |
| 1407001662 | Krawczyk Counseling Services, LLC | Social Worker | 2631 Packerland Dr, Suite 104c, Green Bay, WI 54313-4130 | 2008-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548823420 | Martha Lynn Drew | Licensed Practical Nurse | 3101 Molly Brown Lane, Green Day, WI 54313 | 2019-04-17 |
| 1831691872 | Melanie Hammerbeck | Dentist | 1756 Cardinal Ln, Green Bay, WI 54313 | 2018-03-06 |
| 1649727108 | Amanda Marie Mckeefry | Dental Hygienist | 2304 Lineville Rd, Suite 101, Green Bay, WI 54313 | 2016-09-01 |
| 1326594813 | Kaylee Schartner | Dental Hygienist | 2304 Lineville Road, Suite 100, Suamico, WI 54313 | 2016-08-25 |
| 1134500226 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Road, Green Bay, WI 54313 | 2015-06-15 |
| 1467849307 | Maureen Riordan | Specialist/Technologist | 2957 S Telemark Cir., Green Bay, WI 54313 | 2015-04-17 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1407092737 | Sara Ann Anderson | Registered Nurse | 2691 Shade Tree Ln, Green Bay, WI 54313 | 2008-12-16 |
| 1467601344 | Melissa Lea Socha | Speech-Language Pathologist | 2153 School Lane, Suamiro Elementary, Green Bay, WI 54313 | 2008-09-16 |
| 1003070707 | Anne Marie Hein | Physical Therapist | 3101 S Packerland Dr, Green Bay, WI 54313 | 2008-07-11 |
| Find all providers in zip 54313 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912461385 | We All Rise Counseling Services LLC | Psychologist | 529 S Jefferson St Ste 201, Green Bay, WI 54301-4125 | 2019-01-30 |
| 1457996910 | Jesse Frederick Peterson | Psychologist | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2019-11-08 |
| 1417359324 | Harbor Health and Wellness LLC | Psychologist | 2701 Larsen Rd Ste 216, Green Bay, WI 54303-4863 | 2014-09-23 |
| 1992086748 | Sarah Elisabeth Baumgartner | Psychologist | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2011-09-07 |
| 1942475827 | Jay J Fostner | Psychologist | 130 E Walnut St, #706, Green Bay, WI 54301-4239 | 2008-04-23 |
| 1831229376 | Tara L Robertson | Psychologist | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2007-03-06 |
| 1871693739 | Denver L Johnson | Psychologist | 2900 Saint Anthony Dr, Green Bay, WI 54311-5859 | 2006-09-22 |
| 1023032745 | Irma Catherine Smet | Psychologist | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2006-07-26 |
| 1417972373 | Sarka Evans | Psychologist | 760 Pilgrim Way, Green Bay, WI 54304-5263 | 2006-07-13 |
| 1063454502 | William B Hitch | Psychologist | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2006-06-11 |
| 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.