Active NPI
James Matthew Green, LPC
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1003890724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 862
- Practice address
- 1801 E 5TH St
Suite 108-B
Charlotte, NC 28204-2472 - Phone
- (704) 375-2822
- NPI assigned
- Dec 6, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 862 | NC | Primary |
Addresses
Primary practice location
1801 E 5TH St
Suite 108-B
Charlotte, NC 28204-2472
Mailing address
1801 E 5TH St
Suite 108-B
Charlotte, NC 28204-2472
Phone (704) 375-2822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37036 | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 862 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196121600000",
"number": "1003890724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 E 5TH ST",
"address_2": "SUITE 108-B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042472",
"telephone_number": "704-375-2822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 E 5TH ST",
"address_2": "SUITE 108-B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042472",
"telephone_number": "704-375-2822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JAMES",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2007-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "862",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "37036",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.