Green Psychological Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

112983 Issued in AK

Legal business name

GREEN PSYCHOLOGICAL SERVICES, LLC

Practice address

634 S Bailey St
106
Palmer, AK 99645-6360

Phone

(907) 631-2807

NPI assigned

Jul 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. William Kerst, PH.D.

Title

Owner

Phone

(907) 631-2807

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1548613243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 S BAILEY ST",
            "address_2": "106",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456360",
            "telephone_number": "907-631-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 S BAILEY ST",
            "address_2": "106",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456360",
            "telephone_number": "907-631-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "KERST",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-631-2807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AK",
            "license": "112983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Palmer, AK
• Providers in Palmer, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.