Randy P Green, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00005960 Issued in WA

Practice address

10525 State Ave
Suite 9
Marysville, WA 98271

Phone

(360) 658-6030

Fax

(360) 658-6030

NPI assigned

Feb 15, 2008

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1275701930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 STATE AVE",
            "address_2": "SUITE 9",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "98271",
            "telephone_number": "360-658-6030",
            "fax_number": "360-658-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 STATE AVE",
            "address_2": "SUITE 9",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "98271",
            "telephone_number": "360-658-6030",
            "fax_number": "360-658-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RANDY",
        "middle_name": "P",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00005960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susy Granados, MA60876400
• Kerianne Marie Grant
• Cameryn Elizabeth-Anne Grassanovits, PA-C
• Audrey Gray, MD
• Green Hill View Afh LLC
• Emily May Greenleaf
• Amy R Greig
• James B. Grierson, MD
• David Lloyd Griffith, D.C.
• Diana Gruber

• Mental Health Counselor in Marysville, WA
• Providers in Marysville, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.