Marilyn Katherine Green, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710103647 Issued in VA

Practice address

6308 Ardsley SQ Apt 201a
Virginia Beach, VA 23464-3542

Phone

(314) 456-6460

NPI assigned

Nov 1, 2021

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1700541190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 ARDSLEY SQ APT 201A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643542",
            "telephone_number": "314-456-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 ARDSLEY SQ APT 201A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643542",
            "telephone_number": "314-456-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MARILYN",
        "middle_name": "KATHERINE",
        "credential": "CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710103647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Jane Green, NP
• Jennifer Green, LM, CPM
• Kristi Green, FNP
• Leesa R Green
• Lydia Green
• Mithra Jigme Green, DC
• Sha'Natra Green
• Shennel Green
• Stephanie M Green, LPC
• Tasanee Green

• Addiction (Substance Use Disorder) Counselor in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.