Active NPI
Misti Marie Green, LMHC, LMFT, CRC
- Marriage & Family Therapist
- Bradenton, FL
National Provider Identifier
1104181809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT2905
- Practice address
- 379 6TH Ave W
Bradenton, FL 34205-8820 - Phone
- (941) 782-4100
- Fax
- (941) 782-4101
- NPI assigned
- Jul 9, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH12629 | FL | |
| Marriage & Family Therapist | 106H00000X | MT2905 | FL | Primary |
Addresses
Primary practice location
379 6TH Ave W
Bradenton, FL 34205-8820
Mailing address
PO Box 9478
Bradenton, FL 34206-9478
Phone (941) 782-4299
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH12629 | FL | MD | Mental Health Counselor |
| MT2905 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402617600000",
"number": "1104181809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9478",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342069478",
"telephone_number": "941-782-4299",
"fax_number": "941-782-4301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "379 6TH AVE W",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342058820",
"telephone_number": "941-782-4100",
"fax_number": "941-782-4101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MISTI",
"middle_name": "MARIE",
"credential": "LMHC, LMFT, CRC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-09",
"last_updated": "2014-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH12629",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT2905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
- Christina Ann Graves
- Great Affordable Mental Health
- Great American Assisted Living Community at Bradenton, LLC
- Greater Tampa Bay Physician Specialists, LLC
- David Green, PA
- Tiffany Anne Green, APRN
- Barry Greenberg, D.O.M
- Greenbriar Healthcare Rehabilitation and Nursing Center
- Greenbriar NH, LLC
- Avery R Greene, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.