Active NPI
Betty Miller Green, M.DIV., M.ED., M.A.,
- Psychologist
- Detroit, MI
National Provider Identifier
1629156658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301012675
- Practice address
- 220 Bagley
Suite 1100
Detroit, MI 48226 - Phone
- (313) 961-7990
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301012675 | MI | Primary |
Addresses
Primary practice location
220 Bagley
Suite 1100
Detroit, MI 48226
Mailing address
8749 Lilly Drive
Ypsilanti, MI 48197-9651
Phone (313) 961-7990
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, Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Service Organization | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Detroit, MI
- NPI 1891825808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224460800000",
"number": "1629156658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8749 LILLY DRIVE",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481979651",
"telephone_number": "313-961-7990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 BAGLEY",
"address_2": "SUITE 1100",
"city": "DETROIT",
"state": "MI",
"postal_code": "48226",
"telephone_number": "313-961-7990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "BETTY",
"middle_name": "MILLER",
"credential": "M.DIV., M.ED., M.A.,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2008-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301012675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.