Candace L Green, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-303750

Practice address

1245 Augusta West Pkwy
Augusta, GA 30909-1807

Phone

(706) 868-0389

NPI assigned

Sep 16, 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

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.

• Mama Mentor LLC

  • Lactation Consultant (Non-RN)
  • Martinez, GA
  • NPI 1275288391

  Lactation Consultant, Non-RN

  NPD Authorized official

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1346910882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EVERGREEN DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071391",
            "telephone_number": "706-814-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 AUGUSTA WEST PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091807",
            "telephone_number": "706-868-0389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Evergreen Dr",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "GA",
            "postal_code": "309071391",
            "country_code": "US",
            "telephone_number": "706-814-8083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CANDACE",
        "middle_name": "L",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L-303750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Horizons Counseling Services, LLC
• Greater Image Healthcare Corp
• Dana Leah Greear, MS, RD, LD, MPH
• Green Family Dental, LLC
• Akira Green
• Charles Gray Green Jr., M.D.
• Kendall Nichole Green, NP
• Kristen Green, DMD
• Margaret O Green, MD
• Mary Fisher Green, PA-C

• Lactation Consultant (Non-RN) in Augusta, GA
• Providers in Augusta, GA by specialty
• Lactation Consultant (Non-RN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.