Ernestine Green, MFT, LAC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

553 Beckett Rd
Swedesboro, NJ 08085-1565

Phone

(856) 677-8535

NPI assigned

Dec 23, 2009

Reactivated

Nov 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tina Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1285963173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1560",
            "city": "BELLMAWR",
            "state": "NJ",
            "postal_code": "080995560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 BECKETT RD",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851565",
            "telephone_number": "856-677-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ERNESTINE",
        "credential": "MFT, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "deactivation_date": "2017-03-16",
        "reactivation_date": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "GREEN",
            "credential": "MFT, LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Marriage & Family Therapist in Swedesboro, NJ
• Providers in Swedesboro, NJ by specialty
• Marriage & Family Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.