NPIMap

Organization Active NPI

Green Light Counseling, Inc.

  • Professional Counselor
  • Greensboro, NC
National Provider Identifier
1619287190
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
GREEN LIGHT COUNSELING, INC.
Practice address
301 N Elm St
Ste 801
Greensboro, NC 27401-2083
Phone
(336) 274-1237
Fax
(336) 274-1236
NPI assigned
Oct 18, 2010
Last updated
Jan 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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

Authorized official

Name
Mr. Jason W Strack, LPC
Title
Owner/Ceo
Phone
(336) 274-1237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

301 N Elm St
Ste 801
Greensboro, NC 27401-2083

Mailing address

301 N Elm St
Ste 801
Greensboro, NC 27401-2083
Phone (336) 274-1237

Other identifiers 1

IdentifierTypeStateIssuer
3410070MedicaidNC

National Provider Directory

National Provider Directory

Locations

301 N Elm St
Ste 801
Greensboro, NC 27401
Phone (336) 790-1115

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1619287190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N ELM ST",
            "address_2": "STE 801",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012083",
            "telephone_number": "336-274-1237",
            "fax_number": "336-274-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N ELM ST",
            "address_2": "STE 801",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012083",
            "telephone_number": "336-274-1237",
            "fax_number": "336-274-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LIGHT COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "STRACK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "336-274-1237",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3410070",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.