NPIMap

Individual provider Active NPI

Carla Jay Green, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Winston Salem, NC
National Provider Identifier
1275151128
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
26024 Issued in NC
Practice address
665 W 4TH St
Winston Salem, NC 27101-2701
Phone
(336) 725-8389
Fax
(336) 725-6628
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 26024 NC Primary

Addresses

Primary practice location

665 W 4TH St
Winston Salem, NC 27101-2701

Mailing address

1730 Franciscan Ter Apt H
Winston Salem, NC 27127-7708
Phone (240) 550-6452

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

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1275151128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 FRANCISCAN TER APT H",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271277708",
            "telephone_number": "240-550-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 W 4TH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012701",
            "telephone_number": "336-725-8389",
            "fax_number": "336-725-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CARLA",
        "middle_name": "JAY",
        "credential": "LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "26024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.