Teri Green, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW-12722 Issued in AZ

Practice address

5701 W Talavi Blvd
Suite 180
Glendale, AZ 85306-1886

Phone

(623) 486-8202

Fax

(623) 486-2739

NPI assigned

Jun 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mrs. Theresa Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1467658658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155101",
            "telephone_number": "602-279-7655",
            "fax_number": "602-241-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W TALAVI BLVD",
            "address_2": "SUITE 180",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061886",
            "telephone_number": "623-486-8202",
            "fax_number": "623-486-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TERI",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LCSW-12722",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LMSW-11867",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS",
            "identifier": "LCSW-12722",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL HEALTH EXAMINERS",
            "identifier": "LMSW-11867",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "GREEN",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Frederick Chapman Green Jr., M.D.
• Kara Green, MSN, FNP-BC
• Kelly Robinson Green, MC, LPC, LISAC
• Marshea T Green
• Steven Green, D.D.S.
• Tirzah Green
• Leighanna Greene
• Matthew Greene, (M.S.)
• Greenlight ABA
• Greenspring Mental Health Services

• Mental Health Counselor in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.