Dexter Green, MCAP, CCJAP, ICRCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ADC-010386-2015 Issued in FL

Practice address

15485 Eagle Nest LN
Suite 210
Miami Lakes, FL 33014-2247

Phone

(973) 510-3703

NPI assigned

Aug 21, 2016

Last updated

Aug 21, 2016By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1285189118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CLEVELAND ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202930",
            "telephone_number": "973-510-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15485 EAGLE NEST LN",
            "address_2": "SUITE 210",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142247",
            "telephone_number": "973-510-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DEXTER",
        "credential": "MCAP, CCJAP, ICRCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-21",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-010386-2015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICRC-ADC",
            "identifier": "803591",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCJAP",
            "identifier": "ADC-005091-2014",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAP",
            "identifier": "ADC-010386-2015",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paola Granados
• Virna Granados
• Renee Marie Graziadei
• GRC General Prevention LLC
• Brianna Rose Green, LMHC
• Danielle Nanette Greene, LCSW
• Gregory N Bailey Pac Inc
• Gregory Reed, M.D.
• Greisy Medical Supply Inc
• Gretter Benitez MD PA

• Addiction (Substance Use Disorder) Counselor in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2016; 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.