Jennifer Diane Miller Green, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6722 Issued in NC

Practice address

4280 Piedmont Pkwy Ste 105
Greensboro, NC 27410-8159

Phone

(855) 295-3276

Fax

(888) 588-2752

NPI assigned

May 5, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1144019167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 S MAYFLOWER AVE STE 220",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165239",
            "telephone_number": "818-241-6780",
            "fax_number": "888-588-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 PIEDMONT PKWY STE 105",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108159",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15501 Weston Pkwy Ste 130",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138641",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 Chapel Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272156715",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 Patriot Pl",
            "address_purpose": "LOCATION",
            "city": "Hillsborough",
            "state": "NC",
            "postal_code": "272789333",
            "country_code": "US",
            "telephone_number": "828-455-2790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20826 Torrence Chapel Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "280310320",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4430 Fayetteville Rd Ste 12",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276033612",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JENNIFER",
        "middle_name": "DIANE MILLER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "6722",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "6722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Sue Green, NP
• Edwin Jay Green, MD
• Elissa Clair Green, PA-C
• Garrett Green, PA-C
• James Judd Green Jr., M.D.
• Joy Anna Green, CADC
• Lanatra Green
• Mikaela Renee Green
• Shakira Green
• Tia Antoinette Green

• Psychologist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.