RIVERSIDE PSYCHIATRIC GROUP SC NPI 1154520203

NPI Information

  • NPI: 1154520203
  • Provider Name: RIVERSIDE PSYCHIATRIC GROUP SC
  • Classification: Psychiatry & Neurology - 2084P0800X
  • Specialization: Psychiatry
  • Entity Type: Organization
  • Address: 1325 ANGELS PATH RD
    DE PERE, WI
    ZIP 54115
  • Phone: (920) 338-2855

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NPI Details

RIVERSIDE PSYCHIATRIC GROUP SC is a psychiatry psychiatry neurology in De Pere, WI. The provider is 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. RIVERSIDE PSYCHIATRIC GROUP SC NPI is 1154520203. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1325 ANGELS PATH RD
DE PERE, WI
ZIP 54115-050
Phone: (920) 338-2855
Fax: (920) 338-9270

The provider's authorized official is Howard W Davis .
The authorized official title is President and has the following contact phone number (920) 338-2800.

The enumeration date for this NPI number is 7/17/2007 and was last updated on 1/14/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryWISCONSINNo
2101YM0800XCounselorMental HealthNo
3103T00000XPsychologistWISCONSINNo
4101YP2500XCounselorProfessionalWISCONSINNo
5106H00000XMarriage & Family TherapistWISCONSINNo
61041C0700XSocial WorkerClinicalWISCONSINNo
7101YA0400XCounselorAddiction (Substance Use Disorder)WISCONSINNo
82084P0800XPsychiatry & NeurologyPsychiatryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
132884100MEDICAIDWISCONSIN
20000044550MEDICARE NSCWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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