Psychologie Clinique SC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1530 Issued in WI

Legal business name

PSYCHOLOGIE CLINIQUE SC

Practice address

130 E Walnut St
Suite 410
Green Bay, WI 54301-4239

Phone

(920) 437-4490

Fax

(920) 437-4492

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Valerie Amelie Delain, PH.D.

Title

President

Phone

(920) 437-4490

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669676722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E WALNUT ST",
            "address_2": "SUITE 410",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014239",
            "telephone_number": "920-437-4490",
            "fax_number": "920-437-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E WALNUT ST",
            "address_2": "SUITE 410",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014239",
            "telephone_number": "920-437-4490",
            "fax_number": "920-437-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGIE CLINIQUE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELAIN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "AMELIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-437-4490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "1530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "1530",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL PSYCHOL",
            "identifier": "0810003479",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla E Prosser, OT
• Laura M Prouty, PT
• Ryan Michael Prouty, PHARM.D.
• Lindsay Rose Pruski, O.T.
• Psychological Consulatnts S.C.
• Angela Yvonne Puchalla, LAT, ATC
• Trevor C. Pugh, DO
• Amber L Puissant, PT
• Toni M Pullen, LMT, NCBTMB
• Torri L Pulley, SLP

• Community/Behavioral Health Agency in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.