Khary KJ Green

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

20 Winter St
Pembroke, MA 02359-4965

Phone

(508) 690-8221

NPI assigned

Sep 14, 2023

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1265219000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 DONALD ST APT 1",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021883951",
            "telephone_number": "339-226-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WINTER ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023594965",
            "telephone_number": "508-690-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KHARY",
        "middle_name": "KJ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracious Bay Counseling PLLC
• Naomi Grant
• Samantha Tierney Grasso
• Gray-Fin Consulting
• Rebecca E. Graziano, NP
• Jane Rae Greenip
• Brittany Greenwood, OT, OTD, OTR
• Matthew F Griffin, PA-C
• Lauren Grimard, MOT, OTR/L
• Marie Elizabeth Guerrier, NP

• Mental Health Counselor in Pembroke, MA
• Providers in Pembroke, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.