Active NPI
Mandy Green, MS, LPC
- Professional Counselor
- Houston, TX
National Provider Identifier
1083887376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 60995
- Practice address
- 4803 San Felipe St
Houston, TX 77056-3907 - Phone
- (713) 626-7990
- Fax
- (716) 627-7715
- NPI assigned
- Apr 8, 2008
- Sex
- Female
- 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 | 60995 | TX | Primary |
Addresses
Primary practice location
4803 San Felipe St
Houston, TX 77056-3907
Mailing address
2800 Kirby Dr
Ste B427
Houston, TX 77098-1273
Phone (713) 562-3672
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60995 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interface-Samaritan Counseling Centers | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Houston, TX
- NPI 1245454768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1083887376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 KIRBY DR",
"address_2": "STE B427",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770981273",
"telephone_number": "713-562-3672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4803 SAN FELIPE ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770563907",
"telephone_number": "713-626-7990",
"fax_number": "716-627-7715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MANDY",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "60995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.