Lisa Michelle Green, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401009728 Issued in MI

Practice address

835 Mason St Ste B220
Dearborn, MI 48124-2262

Phone

(313) 561-9064

NPI assigned

Sep 28, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Wayne Family Health CentersGroup PAC ID 4082617998, 15 clinicians

Michigan Modern Psychology Group PLLCGroup PAC ID 6103162896, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.green.1@17288.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan Modern Psychology Group,PLLC

  • Clinical Psychologist
  • Dearborn, MI
  • NPI 1447701255
  Medicare reassignment Care Compare group NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Inkster, MI
  • NPI 1972530277
  Medicare reassignment Care Compare group NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Ecorse, MI
  • NPI 1316510860
  NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Lincoln Park, MI
  • NPI 1508280116
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1043795628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13262 CHESTNUT LN",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806347",
            "telephone_number": "734-732-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MASON ST STE B220",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242262",
            "telephone_number": "313-561-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Medical Supply LLC
• Green Valley Home Health
• Bythie Green
• Davietta Green
• Kelsey Joy Green
• Malika Christine Green
• Mallori Estelle Green
• Miracle Ri'Anna Green
• Greenfield Health Pharmacy Inc
• Greenfield Medical Center

• Professional Counselor in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.