Active NPI
Marvin L Green, LPC
- Professional Counselor
- Goose Creek, SC
National Provider Identifier
1508822628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4189
- Practice address
- 179 Fox Chase Dr
Goose Creek, SC 29445-5413 - Phone
- (843) 830-2979
- Fax
- (843) 572-6992
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4189 | SC | Primary |
Addresses
Primary practice location
179 Fox Chase Dr
Goose Creek, SC 29445-5413
Mailing address
179 Fox Chase Dr
Goose Creek, SC 29445-5413
Phone (843) 830-2979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508822628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 FOX CHASE DR",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294455413",
"telephone_number": "843-830-2979",
"fax_number": "843-572-6992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 FOX CHASE DR",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294455413",
"telephone_number": "843-830-2979",
"fax_number": "843-572-6992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MARVIN",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "4189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.