SHELLEY BOEHM MATTIA MD,ADULT PSYCHIATRY, LLC
NPI 1427410992
Clinic/Center - Adult Mental Health in Green Bay, WI

Active since March 24, 2016
428 DOTY ST, GREEN BAY, WI 54301(920) 965-6768(920) 965-6769 Get Directions Write a Review

NPPES record last updated: October 4, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shelley Boehm Mattia Md,adult Psychiatry, Llc NPPES

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

SHELLEY BOEHM MATTIA MD,ADULT PSYCHIATRY, LLC (NPI 1427410992) is a healthcare organization registered as an adult mental health in Green Bay, Wisconsin and active in the NPI registry since March 2016. The organization lists Shelley Kathryn Boehm Mattia, Licensed Physician, as its authorized official.

NPPES Registry Identity

NPI1427410992
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameSHELLEY BOEHM MATTIA MD,ADULT PSYCHIATRY, LLC
Location Address428 DOTY STGreen Bay, WI 54301-4509
Mailing Address428 Doty StGreen Bay, WI 54301-4509 · (920) 965-6768 · Fax (920) 965-6769
Fax(920) 965-6769
Organization SubpartNo
Authorized OfficialShelley Kathryn Boehm MattiaLicensed Physician · (920) 246-4925
Enumeration DateMarch 24, 2016
Last NPPES UpdateOctober 4, 2016
NPI 1427410992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
License Licensed in WI · 39641
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
428 DOTY ST, Green Bay, WI 54301

Other Identifiers 2

Medicaid32453500WI
Medicare UPING01884WI

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 Shelley Boehm Mattia Md,adult Psychiatry, LLC's NPI number?

The NPI number for Shelley Boehm Mattia Md,adult Psychiatry, LLC is 1427410992. It was assigned to this organization in the NPPES registry on March 24, 2016.

Where is Shelley Boehm Mattia Md,adult Psychiatry, LLC located?

Shelley Boehm Mattia Md,adult Psychiatry, LLC is located at 428 Doty St, Green Bay, WI 54301. The listed phone number is (920) 965-6768.

What is Shelley Boehm Mattia Md,adult Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Shelley Boehm Mattia Md,adult Psychiatry, LLC was last updated on October 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.