Active NPI
Patricia Ellen Green, MA ., LPCC
- Professional Counselor
- Santa Fe, NM
National Provider Identifier
1629130190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0075291
- Practice address
- 11 Calle Medico Ste 5
Santa Fe, NM 87505-4705 - Phone
- (505) 577-2959
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 0075291 | NM | Primary |
Addresses
Primary practice location
11 Calle Medico Ste 5
Santa Fe, NM 87505-4705
Mailing address
PO Box 5887
Santa Fe, NM 87502-5887
Phone (505) 577-2959
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0075291 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629130190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5887",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875025887",
"telephone_number": "505-577-2959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 CALLE MEDICO STE 5",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054705",
"telephone_number": "505-577-2959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "PATRICIA",
"middle_name": "ELLEN",
"credential": "MA ., LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0075291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.