Samuel Ellis Green, M.A., L.M.H.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

003591 Issued in NY

Practice address

9027 Sutphin Blvd
Jamaica, NY 11435-3647

Phone

(718) 526-8400

Fax

(718) 297-8658

NPI assigned

Oct 20, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Transitional Services for New York, Inc

  • Community/Behavioral Health Agency
  • Jamaica, NY
  • NPI 1457418337
  NPD (past)
• Transitional Services for Ny

  • Counseling Psychologist
  • Jamaica, NY
  • NPI 1780855213
  NPD (past)

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1255735247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9027 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353647",
            "telephone_number": "718-526-8400",
            "fax_number": "718-297-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9027 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353647",
            "telephone_number": "718-526-8400",
            "fax_number": "718-297-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SAMUEL",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "credential": "M.A., L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ceceile McIntosh Green, MS, PHD CANDIDATE
• Fredrique Green
• Latoya Green
• Mildred Green
• Nordia Green
• Robert Greenbaum, MD
• Chana Greenberg, RN, BSN
• Martin Greenberg
• Brittany I Greene, RBT
• Deborah J Greene, LCSW

• Mental Health Counselor in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.