Mackenzie Ione Green

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701013800 Issued in VA

Practice address

1215 Mall Dr
North Chesterfield, VA 23235-4737

Phone

(804) 594-3690

NPI assigned

Jul 26, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Advanced Behavioral Health Services, LLC

  • Community/Behavioral Health Agency
  • North Chesterfield, VA
  • NPI 1780923292
  NPD

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1346078664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10331 GLENDYE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232352124",
            "telephone_number": "804-385-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 MALL DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354737",
            "telephone_number": "804-594-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MACKENZIE",
        "middle_name": "IONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701013800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Ryan Gray, PHARMD.
• Greater Community Services LLC.
• Greater Unity Adult Services
• Greater Unity Employment Services, LLC
• Ana Green, RBT
• Yolanda Nicole Green, MMP
• Charles Greene
• Daniel Phillip Greene, M.D.
• Valerie Morgan Greenleaf, PT, DPT
• Greg Amodeo LLC

• Professional Counselor in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.