Organization Active NPI

Green Acres Counseling and Group Services LLC

  • Counselor
  • Cleveland, OH
National Provider Identifier
1417514654
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
GREEN ACRES COUNSELING AND GROUP SERVICES LLC
Practice address
3100 E 45TH St Ste 212C
Cleveland, OH 44127-1093
Phone
(216) 438-2846
NPI assigned
May 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carolyn Green, LIDCD.161732
Title
Owner
Phone
(216) 633-8644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

3100 E 45TH St Ste 212C
Cleveland, OH 44127-1093

Mailing address

2283 E 100TH St
Cleveland, OH 44106-3501
Phone (216) 633-8644

Other identifiers 1

IdentifierTypeStateIssuer
0287012MedicaidOH

National Provider Directory

National Provider Directory

Locations

17325 Euclid Ave
Ste 4031
Cleveland, OH 44112

3100 E 45th St
Ste 212C
Cleveland, OH 44127
Phone (216) 438-2846

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1417514654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2283 E 100TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441063501",
            "telephone_number": "216-633-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 212C",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271093",
            "telephone_number": "216-438-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN ACRES COUNSELING AND GROUP SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-633-8644",
        "authorized_official_credential": "LIDCD.161732"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0287012",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.