Carry L Green, MA LMHP LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-17306 Issued in AZ

Practice address

9014 S Central Ave
Phoenix, AZ 85042-8304

Phone

(602) 230-7373

Fax

(602) 230-5105

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bryan Medical CenterGroup PAC ID 4284628652, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370
  Medicare reassignment Care Compare group NPD
• Bryan Medical Center

  • Counseling Psychologist
  • Lincoln, NE
  • NPI 1497809966

  Professional

  NPD
• Bryan Medical Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lincoln, NE
  • NPI 1629157789
  NPD
• Molly M. Burns, Psy.D., P.C.

  • Clinical Psychologist
  • Lincoln, NE
  • NPI 1417021155
  NPD (past)
• Southpointe Family Resource Center, P.C.

  • Clinical Psychologist
  • Boulder, CO
  • NPI 1699822981
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1447318282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122020",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9014 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850428304",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-5105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 S 16th St",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685023796",
            "country_code": "US",
            "telephone_number": "402-890-7434",
            "fax_number": "402-328-8383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CARRY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MA LMHP LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2389",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1316",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "84002",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "234934",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green MSP LLC
• Amber Stieg Green
• Arneice Melinda Green
• Brandon J Green, MD
• Brooke Kalea Green, DPT
• Elizabeth Anne Green, MD
• Emma Kaitlyn Green, OTR/L
• Jared Green
• Jennifer Lindsey Atwood Green, RN, PMHNP-BC
• Jessica Green

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.