Kevin M Green, PHD, MS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

50020653902 Issued in UT

Practice address

199 N 290 W
Suite 150
Lindon, UT 84042-1810

Phone

(801) 406-8994

NPI assigned

Sep 5, 2013

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascendant Behavioral Health LLCGroup PAC ID 1850673187, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascendant Behavioral Health LLC

  dba Ascendant Behavioral Health DBA LifeStance

  • Clinical Social Worker
  • Murray, UT
  • NPI 1689128605
  Medicare reassignment Care Compare group NPD
• Addo Recovery

  • Marriage & Family Therapist
  • Lindon, UT
  • NPI 1689912636
  NPD (past)

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1649605965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-359-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 N 290 W",
            "address_2": "SUITE 150",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421810",
            "telephone_number": "801-406-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "393 E 2nd N",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401605",
            "country_code": "US",
            "telephone_number": "208-359-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "50020653902",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-6350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Godfrey, FNP-C
• Cari Nicole Goyne, DMD
• Graceful Healing, Inc
• Makenna May Graff, FNP
• Brandy Green, MSW, LCSW
• Kathrine Greenburg, LMT
• Jennifer Lee Hansen
• Cydnie Smith Harp, APRN, CNP
• Weston Thorpe Harris, BC-HIS
• Kazuyoshi Hayashi, LCSW

• Marriage & Family Therapist in Lindon, UT
• Providers in Lindon, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.