Organization Active NPI

Greener Side Counseling, LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1689168304
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11413 Issued in FL
Legal business name
GREENER SIDE COUNSELING, LLC
Practice address
9957 Moorings Dr Ste 302
Jacksonville, FL 32257-2415
Phone
(888) 793-2304
Fax
(888) 793-2304
NPI assigned
Jun 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Megan Rae Rockwood, LMHC,MCAP,CSOTP,QSNPI 1972884252
Title
Owner
Phone
(888) 793-2304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH11413 FL Primary

Addresses

Primary practice location

9957 Moorings Dr Ste 302
Jacksonville, FL 32257-2415

Mailing address

9957 Moorings Dr Ste 302
Jacksonville, FL 32257-2415
Phone (888) 793-2304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241008001227 FL Part B Supplier - Clinic/Group Practice 8527599059 Receives reassigned benefits from 5 practitioners
Practice locations: Jacksonville, FL; Orange Park, FL

National Provider Directory

National Provider Directory

Locations

11363 San Jose Blvd
Ste 100
Jacksonville, FL 32223
Phone (888) 793-2304

9957 Moorings Dr
Ste 302
Jacksonville, FL 32257
Phone (888) 793-2304

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1689168304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9957 MOORINGS DR STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572415",
            "telephone_number": "888-793-2304",
            "fax_number": "888-793-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9957 MOORINGS DR STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572415",
            "telephone_number": "888-793-2304",
            "fax_number": "888-793-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENER SIDE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "ROCKWOOD",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-793-2304",
        "authorized_official_credential": "LMHC,MCAP,CSOTP,QS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.