DR. BONNIE RAE NUSSBAUM PH.D.
NPI 1114071289
Psychologist - Clinical in Green Bay, WI

Q: What is Bonnie Nussbaum's NPI number?

The NPI number for Bonnie Nussbaum is 1114071289. It was assigned to this individual provider in the NPPES registry on January 23, 2007.

Q: What is Bonnie Nussbaum's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Bonnie Nussbaum was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 23, 2007

3600 VELP AVE STE 4-A, GREEN BAY, WI 54313(920) 884-7445(920) 844-7449 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Dr. Bonnie Rae Nussbaum Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BONNIE RAE NUSSBAUM PH.D. (NPI 1114071289) is an individual clinical provider in Green Bay, Wisconsin, licensed in Wisconsin (1598-057) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1114071289

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. BONNIE RAE NUSSBAUMCredential: PH.D.

Location Address3600 VELP AVE STE 4-AGreen Bay, WI 54313-6503

Mailing Address3600 Velp Ave Ste 4-aGreen Bay, WI 54313-6503 · (920) 884-7445 · Fax (920) 844-7449

Phone(920) 884-7445

Fax(920) 844-7449

Sole ProprietorYes

Enumeration DateJanuary 23, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1114071289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in WI · 1598-057

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3600 VELP AVE STE 4-A, Green Bay, WI 54313

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Other Identifiers 1

Medicare ID-Type Unspecified84700WI

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonnie Nussbaum's NPI number?

The NPI number for Bonnie Nussbaum is 1114071289. It was assigned to this individual provider in the NPPES registry on January 23, 2007.

Where is Bonnie Nussbaum located?

Bonnie Nussbaum practices at 3600 Velp Ave Ste 4-A, Green Bay, WI 54313. The listed phone number is (920) 884-7445.

What is Bonnie Nussbaum's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Bonnie Nussbaum was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.