Jonathan Andrew Green

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1000 Chinaberry Dr Ste 903
Bossier City, LA 71111-2455

Phone

(318) 459-6795

Fax

(318) 626-5429

NPI assigned

Apr 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jai Green Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Miss-Lou Addiction Clinic

  • Case Manager/Care Coordinator
  • Jonesboro, LA
  • NPI 1205354974
  NPD

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1588306898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 W 4TH ST APT 16",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394015860",
            "telephone_number": "601-964-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHINABERRY DR STE 903",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112455",
            "telephone_number": "318-459-6795",
            "fax_number": "318-626-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jgreen.mbhs@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1000 Chinaberry Dr Ste 903",
            "city": "Bossier City",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711112455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAI",
            "last_name": "GREEN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Grandir Counseling and Restoration LLC
• Janelle Lavon Grant
• Jacqueline J Gray, MD
• Jonathan Simon Gray, MD
• Carolyn Grayson
• Patricia Green
• Monica Greene, DHA, RN, BSN, MLT
• Madelynne Marie Greer
• Courtney Mooney Gregory
• Sean Gregory, M.S., PLPC

• Mental Health Counselor in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.