Krystal Cheyenne Green, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79120 Issued in TX

Practice address

7208 Lapin CV
Austin, TX 78739-2090

Phone

(512) 749-2670

NPI assigned

Jan 9, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1124732771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7208 LAPIN CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787392090",
            "telephone_number": "512-749-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7208 LAPIN CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787392090",
            "telephone_number": "512-749-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KRYSTAL",
        "middle_name": "CHEYENNE",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFIED COUNSELORS",
            "identifier": "889202",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wintergreentherapy.com",
            "affiliation": "N",
            "endpointDescription": "Professional Website",
            "address_1": "7208 Lapin Cv",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787392090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keciana Green
• Kelly Elizabeth Green, PH.D.
• Kelly Patrick Green, O.D.
• Kindrel Green
• Kristina Lynne Green, OT
• Laura A Green, OTR/L
• Louis Green
• Lucila Stephanie Green
• Pierce Green, LPC
• Sage Taylor Green, D.O.

• Professional Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Professional Counselor in Texas

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

Verify at the official NPI Registry.