Kerry M Green, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-7253 Issued in ID

Practice address

250 Northwest Blvd Ste 101a
Coeur D Alene, ID 83814-2971

Phone

(208) 661-9200

NPI assigned

Aug 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kootenai Health, Inc.

  • Psychiatry Physician
  • Coeur d'Alene, ID
  • NPI 1174661151

  Multi-Specialty

  Medicare reassignment NPD
• Kootenai Health, Inc.

  dba Kootenai Health Pharmacy

  • Community/Retail Pharmacy
  • Hayden, ID
  • NPI 1235986290
  NPD
• Kootenai Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Coeur d'Alene, ID
  • NPI 1609925023
  NPD
• Kootenai Health, Inc.

  dba Kootenai Medical Center Group

  • Emergency Medicine Physician
  • Coeur d'Alene, ID
  • NPI 1235288655

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1073161717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NORTHWEST BLVD STE 101A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NORTHWEST BLVD STE 101A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142971",
            "telephone_number": "208-661-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 N Ironwood Pl",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142696",
            "country_code": "US",
            "telephone_number": "208-625-4803",
            "fax_number": "208-625-5774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KERRY",
        "middle_name": "M",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-7253",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-7253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Graybeal, PHA
• Paul A Grayhek, LCSW
• Joni Rae Grayson, LMT
• Anastacia Green
• Christopher Winslow Green, LCSW
• Leslie Green, LMT
• Margaret Marie Green, PSYD
• William M Green, PHD
• Spencer D Greendyke, MD
• Alissa Greene

• Mental Health Counselor in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.