Organization Active NPI

Psychological Consulatnts S.C.

  • Clinical Psychologist
  • Green Bay, WI
National Provider Identifier
1992920300
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2463-057 Issued in WI
Legal business name
PSYCHOLOGICAL CONSULATNTS S.C.
Practice address
130 E. Walunt Street
604
Green Bay, WI 54301
Phone
(920) 437-3854
Fax
(920) 437-7488
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Ursula Bertrand, PH.D.NPI 1932324332
Title
President
Phone
(920) 437-3854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 2463-057 WI Primary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X 1042 WI

Addresses

Primary practice location

130 E. Walunt Street
604
Green Bay, WI 54301

Mailing address

130 E. Walunt Street
604
Green Bay, WI 54301
Phone (920) 437-3854

Other identifiers 1

IdentifierTypeStateIssuer
42120100MedicaidWI

National Provider Directory

National Provider Directory

Locations

130 E Walnut St
Ste 604
Green Bay, WI 54301
Phone (920) 437-3854

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1992920300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E. WALUNT STREET",
            "address_2": "604",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-437-3854",
            "fax_number": "920-437-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E. WALUNT STREET",
            "address_2": "604",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-437-3854",
            "fax_number": "920-437-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL CONSULATNTS S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BERTRAND",
        "authorized_official_first_name": "URSULA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-437-3854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2463-057",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "WI",
            "license": "1042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42120100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.