Kelley Nicole Greene

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1552030324 Issued in CA

Practice address

12183 Locksley LN
Auburn, CA 95602-2004

Phone

(831) 975-1121

NPI assigned

Mar 6, 2024

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": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1750148656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12183 LOCKSLEY LN",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956022004",
            "telephone_number": "831-975-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12183 LOCKSLEY LN",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956022004",
            "telephone_number": "831-975-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KELLEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1552030324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Green
• Cheyenne Kay Elisio Green
• Kiara Mae Green
• Maria Aurora Green
• Savannah Green
• Alisa Greenhill, MFT
• James M Greenlee, D.C.
• Elizabeth Ann Gregersen
• Joan Gregg, P.T.
• Elinor Espineli Gregory, O.T.

• Addiction (Substance Use Disorder) Counselor in Auburn, CA
• Providers in Auburn, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.