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DR. BRUCE J. ROBERTSON PHD NPI 1396770434


NPI Information

NPI: 1396770434
Provider Name: DR. BRUCE J. ROBERTSON, PHD
Classification: Psychologist - 103T00000X
Entity Type: Individual
Address:
2631 PACKERLAND DR
SUITE 104-C
GREEN BAY, WI
ZIP 54313
Phone: (920) 965-7701
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DR. Bruce J. Robertson, PHD is a psychologist in Green Bay, WI. The provider is 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. DR. Bruce J. Robertson, PHD NPI is 1396770434. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2631 PACKERLAND DR
SUITE 104-C
GREEN BAY, WI
ZIP 54313-130
Phone: (920) 965-7701
Fax: (920) 497-4956

The enumeration date for this NPI number is 7/11/2006 and was last updated on 9/12/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologist1992-057WISCONSINYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
185206-0022MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN
239699400MEDICAIDWISCONSIN

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: 11/14/2023

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