Douglas Green, MFT, LPCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

47730 Issued in CA

Practice address

12304 Santa Monica Blvd Ste 327
Los Angeles, CA 90025-7207

Phone

(818) 624-3637

Fax

(818) 905-1881

NPI assigned

Mar 7, 2007

Last updated

Mar 25, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 8, 2024 through Feb 8, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1699806216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD STE 327",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257207",
            "telephone_number": "818-624-3637",
            "fax_number": "818-905-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD STE 327",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257207",
            "telephone_number": "818-624-3637",
            "fax_number": "818-905-1881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5550 Topanga Canyon Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913677448",
            "country_code": "US",
            "telephone_number": "818-624-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MFT, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dante Heu Green Jr.
• Deborah Anna Green, MSW, LCSW
• Dennis M Green, M.D.
• Devin Green, LCSW
• Douglas Green
• Dynasty Dornae Green, RN
• Elissa Beth Green, DMD
• Elyse Green
• Eugene Green, O.D.
• Felecia Green, PA

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.