NPIMap

Organization Active NPI

Greene Mental Wellness, PLLC

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Wake Forest, NC
National Provider Identifier
1093456378
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
Legal business name
GREENE MENTAL WELLNESS, PLLC
Practice address
833 Wake Forest Business Park Ste F
Wake Forest, NC 27587-7184
Phone
(919) 230-1419
Fax
(984) 278-6610
NPI assigned
Apr 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Catina Greene, DNP, PMHNP, FNPNPI 1912443656
Title
Owner
Phone
(919) 667-5888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0807X Primary

Addresses

Primary practice location

833 Wake Forest Business Park Ste F
Wake Forest, NC 27587-7184

Mailing address

6621 Prescott Shore Dr
Wake Forest, NC 27587-8564
Phone (919) 667-5888

Other names 1

  • Greene Mental Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220721000962 NC Part B Supplier - Clinic/Group Practice 9537540653 Receives reassigned benefits from 3 practitioners
Practice locations: Wake Forest, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1093456378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 PRESCOTT SHORE DR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275878564",
            "telephone_number": "919-667-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 WAKE FOREST BUSINESS PARK STE F",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877184",
            "telephone_number": "919-230-1419",
            "fax_number": "984-278-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE MENTAL WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-02",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "CATINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-667-5888",
        "authorized_official_credential": "DNP, PMHNP, FNP"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greene Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greene Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.