Matthew Green, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1208 Porter Wagoner Blvd
Suite 4
West Plains, MO 65775-1854

Phone

(417) 257-4031

Fax

(417) 256-4104

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1679697957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 PORTER WAGONER BLVD",
            "address_2": "SUITE 4",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751854",
            "telephone_number": "417-257-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 PORTER WAGONER BLVD",
            "address_2": "SUITE 4",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751854",
            "telephone_number": "417-257-4031",
            "fax_number": "417-256-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MATTHEW",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499305423",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffery D Gordon, M.D.
• Alicia Goshorn, PTA
• Green Acres Home of West Plains Inc
• Amanda Marie Green, MT-BC
• Christopher Scott Green, ATC/L
• Thomas H Green, D.C.
• Melany Hanna Grinstaff
• Missy Fay Grinstaff
• DJ Gross, APRN
• Guardian Flight LLC

• Professional Counselor in West Plains, MO
• Providers in West Plains, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.