Jamelle Gardine Greene, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9349 Issued in MA

Practice address

22 Carriage LN
South Hadley, MA 01075-2198

Phone

(508) 330-0413

NPI assigned

Jun 7, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Sep 4, 2020 through Sep 4, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Tessera Psychology Services LLC

  • Clinical Psychologist
  • South Hadley, MA
  • NPI 1245821081
  NPD Authorized official
• Ann E Drouilhet

  • Community/Behavioral Health Agency
  • Framingham, MA
  • NPI 1831510015
  NPD (past)

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1306107222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CARRIAGE LN",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010752198",
            "telephone_number": "508-330-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CARRIAGE LN",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010752198",
            "telephone_number": "508-330-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JAMELLE",
        "middle_name": "GARDINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "9349",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Grant
• Laura Diane Maynard Grant, PSYD
• Cora Ruth Graves
• Marjory Roberts Gray, PH.D.
• Zoe Verne Greco, OTR/L
• Sean Gremillion, PT
• Rachel Guerin
• Kindreth D Hamilton, LIC. AC., MAOM, MS
• Johanna Hammer, LICSW
• Hampden Eye Physicians and Surgeons, P.C.

• Clinical Psychologist in South Hadley, MA
• Providers in South Hadley, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.