Rebecca Ann Green, CSAC, ICS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2037-132 Issued in WI

Practice address

811 Harding St
Suite 1
Waupaca, WI 54981-2012

Phone

(715) 258-6287

Fax

(920) 734-2824

NPI assigned

Feb 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1497994446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 HARDING STREET",
            "address_2": "SUITE 1",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549815286",
            "telephone_number": "715-258-6287",
            "fax_number": "920-734-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 HARDING ST",
            "address_2": "SUITE 1",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812012",
            "telephone_number": "715-258-6287",
            "fax_number": "920-734-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "CSAC, ICS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-16",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2037-132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Glodowski, MS,LAT,ATC
• Kathleen Ann Goodreau
• Logan Robert Gorges, M.D.
• Jessica A Grant, APNP
• Spencer Wolf Greaves, MD
• Elizabeth Marie Greene
• Dante Grorich, D.C.
• Elizabeth A Gross, DPT
• Melissa A Habeck
• Holly L Haberman, MD

• Addiction (Substance Use Disorder) Counselor in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.