Active NPI
Green Meadows Wellness Center LLC
- Clinical Psychologist
- Woodbine, KY
National Provider Identifier
1083072250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- GREEN MEADOWS WELLNESS CENTER LLC
- Practice address
- 1640 Meadow Creek Road
Woodbine, KY 40771 - Phone
- (606) 280-5581
- NPI assigned
- Feb 3, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandra Nantz
- Title
- Sole MBR.
- Phone
- (606) 280-5581
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
1640 Meadow Creek Road
Woodbine, KY 40771
Mailing address
PO Box 98
Woodbine, KY 40771-0098
Phone (606) 280-5581
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1454457600000",
"number": "1083072250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 98",
"city": "WOODBINE",
"state": "KY",
"postal_code": "407710098",
"telephone_number": "606-280-5581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 MEADOW CREEK ROAD",
"city": "WOODBINE",
"state": "KY",
"postal_code": "40771",
"telephone_number": "606-280-5581"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN MEADOWS WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-03",
"last_updated": "2016-02-03",
"status": "A",
"authorized_official_last_name": "NANTZ",
"authorized_official_first_name": "SANDRA",
"authorized_official_title_or_position": "SOLE MBR.",
"authorized_official_telephone_number": "606-280-5581"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbine, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.