Shelley A. Green, MS/LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5877 Issued in OK

Practice address

2603 Rutherford St
Muskogee, OK 74403-7639

Phone

(918) 687-3532

NPI assigned

Apr 17, 2007

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

Other names 1

• Shelley A. Green Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Muskogee County Council of Youth Service

  • Community/Behavioral Health Agency
  • Muskogee, OK
  • NPI 1215173133
  NPD (past)
• Muskogee County Council of Youth Services

  • Community/Behavioral Health Agency
  • Muskogee, OK
  • NPI 1639251457
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1396960878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 RUTHERFORD ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744037639",
            "telephone_number": "918-687-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 RUTHERFORD ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744037639",
            "telephone_number": "918-687-3532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4009 Eufaula Ave",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744031132",
            "country_code": "US",
            "telephone_number": "918-682-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHELLEY",
        "middle_name": "A.",
        "credential": "MS/LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "GREEN",
            "middle_name": "A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrew Fay Green
• Carolyn Green
• Cassie Lynn Green, APRN,FNP-BC
• Christopher Green
• Raelee Marie Green
• Deborah Lynn Greener, OTR
• Timothy Francis Greener, R.T.(R)(MR)(ARRT)
• Frank Jawayne Greenhaw Jr., DC
• Lesa Marie Greenhaw, RN
• Taylor Mitchell Greenhaw

• Professional Counselor in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.