Connie Green, CDCA. QBHS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

586 W Main St
Wilmington, OH 45177-2123

Phone

(937) 599-4028

NPI assigned

Aug 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Phoenix Center, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ironton, OH
  • NPI 1225670813

  Addiction (Substance Use Disorder)

  NPD
• Phoenix Center, Inc.

  • General Practice Physician
  • Ironton, OH
  • NPI 1366379075

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1285308486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772123",
            "telephone_number": "937-599-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772123",
            "telephone_number": "937-599-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Orab",
            "state": "OH",
            "postal_code": "451540296",
            "country_code": "US",
            "telephone_number": "119-377-1231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CONNIE",
        "credential": "CDCA. QBHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgreen@thephoenixcenters.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "149 Mercy Blvd",
            "city": "Mount Orab",
            "state": "OH",
            "country_code": "US",
            "postal_code": "451540296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Smith Grace
• Deborah Jean Grant
• Lori A Grant, LSW
• Greater Tomorrow Health, LLC
• Greater Tomorrow Wellness, LLC
• Kristen Leigh Greenawalt, BS PHARM
• Greene Memorial Hospital Services, Inc
• Stephanie Jill Greene, APRN-BC
• Stephanie Lynn Greene
• Sharon A Griffith, CRNA

• All providers in Wilmington, OH
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.