Active NPI
Stephanie Green
- Professional Counselor
- South Boston, VA
National Provider Identifier
1366895328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701006696
- Practice address
- 554 N Main St Ste 104
South Boston, VA 24592-3283 - Phone
- (434) 470-7995
- NPI assigned
- Jul 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701006696 | VA | Primary |
Addresses
Primary practice location
554 N Main St Ste 104
South Boston, VA 24592-3283
Mailing address
PO Box 88
South Boston, VA 24592-0088
Phone (434) 470-7995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701006696 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
Interoperability endpoints
- stephaniegreen@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1366895328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 88",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245920088",
"telephone_number": "434-470-7995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 N MAIN ST STE 104",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245923283",
"telephone_number": "434-470-7995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-14",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701006696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Boston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.