Active NPI
Brandeis Green, PHD
- Clinical Psychologist
- Decatur, GA
National Provider Identifier
1184010241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003857
- Practice address
- 250 N Arcadia Ave
Decatur, GA 30030-2115 - Phone
- (404) 321-6111
- NPI assigned
- Apr 15, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003857 | GA | Primary |
Addresses
Primary practice location
250 N Arcadia Ave
Decatur, GA 30030-2115
Mailing address
250 N Arcadia Ave
Decatur, GA 30030-2115
Phone (404) 321-6111
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003857 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Standpoint Therapy & Organizational Consulting | Current | Accepting new patients | |
| Atlanta Trauma Therapy & Consulting | Clinical | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Psychologist
- College Park, GA
- NPI 1619746534
-
- Community/Behavioral Health Agency
- Atlanta, GA
- NPI 1992207989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429056000000",
"number": "1184010241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N ARCADIA AVE",
"city": "DECATUR",
"state": "GA",
"postal_code": "300302115",
"telephone_number": "404-321-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 N ARCADIA AVE",
"city": "DECATUR",
"state": "GA",
"postal_code": "300302115",
"telephone_number": "404-321-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "BRANDEIS",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-15",
"last_updated": "2015-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "003857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.