Ebony Green, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

AZSLP11463 Issued in AZ

Practice address

501 W Ray Rd Ste 1-2
Chandler, AZ 85225-7284

Phone

(480) 296-2363

Fax

(480) 685-9875

NPI assigned

Nov 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Casa Speech Therapy, LLC

  • Hearing and Speech Clinic/Center
  • Chandler, AZ
  • NPI 1255801114

  Single Specialty, TX

  Medicare reassignment NPD Authorized official
• A Better Learning Environment LLC

  • Speech-Language Pathologist
  • Apache Junction, AZ
  • NPI 1255698817

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1416009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1285030486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 E MARY LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951453",
            "telephone_number": "210-701-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W RAY RD STE 1-2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257284",
            "telephone_number": "480-296-2363",
            "fax_number": "480-685-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "EBONY",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-15",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "AZSLP11463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gray'S Counseling of Arizona, PLLC
• Natalie Greco, MD
• Green Plus Physical Therapy and Wellness LLC
• Alisha Renee Green, OTR L
• Arnita Green, RPH
• Grace Green
• Jennifer Ann Green, FNP-C
• Paige K Green
• Emily Marie Greenbrook, M.S
• Hannah Jane Greene, RBT

• Speech-Language Pathologist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.