NPIMap

Organization Active NPI

Bellin Psychiatric Center Inc

Doing business as Bellin Behavior Health-East Depere

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • De Pere, WI
National Provider Identifier
1144283318
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BELLIN PSYCHIATRIC CENTER INC
Doing business as
Bellin Behavior Health-East Depere
Practice address
555 Redbird Cir
De Pere, WI 54115-7977
Phone
(920) 338-6830
NPI assigned
Apr 10, 2006
Last updated
Jul 10, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BELLIN PSYCHIATRIC CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Denise K Stroobants
Title
Credentialing Specialist
Phone
(920) 445-7226

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X WI
Professional Counselor 101YP2500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X

Addresses

Primary practice location

555 Redbird Cir
De Pere, WI 54115-7977

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7210

Other names 1

  • BELLIN BEHAVIOR HEALTH-EAST DEPERE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000884 WI Part B Supplier - Clinic/Group Practice 4486551058 Receives reassigned benefits from 107 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wrightstown, WI; Sturgeon Bay, WI; Pulaski, WI; Oconto Falls, WI; Oconto, WI; Manitowoc, WI; Kewaunee, WI; Green Bay, WI…

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Part of
Bellin Psych Center Inc

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1144283318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 REDBIRD CIR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157977",
            "telephone_number": "920-338-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN PSYCHIATRIC CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLIN PSYCHIATRIC CENTER INC",
        "enumeration_date": "2006-04-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "920-445-7226"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BELLIN BEHAVIOR HEALTH-EAST DEPERE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BELLIN BEHAVIOR HEALTH-EAST DEPERE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.