Corey Matthew Green, PEER SUPPORTER

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

180368 Issued in OH

Practice address

1034 Harrisburg Pike
Columbus, OH 43223-2525

Phone

(614) 276-4840

NPI assigned

Aug 20, 2021

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

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.

• House of Hope for Recovery

  dba House of Hope

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1720149115
  NPD (past)

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1306512132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 HARRISBURG PIKE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232525",
            "telephone_number": "614-276-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 HARRISBURG PIKE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232525",
            "telephone_number": "614-276-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "COREY",
        "middle_name": "MATTHEW",
        "credential": "PEER SUPPORTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-20",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "0002753",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "180368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigitte M. Green, LISW-S
• Candace Green, CNP
• Caremal Green, CT
• Chancis Green
• Clarence Green
• Dashianna Green, M ED., BCBA, COBA
• Delores Kelli Green
• Dominique Chantel Green
• Elise Nicole Green
• Elizabeth J Green, MSW, LSW

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.