Madison Bailee Green, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCCANDIDATE10997 Issued in OK

Practice address

907 W Caddo St
Cleveland, OK 74020-4201

Phone

(539) 325-0739

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grand Lake Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520

  OK

  Medicare reassignment
• Grand Lake Mental Health Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kansas, OK
  • NPI 1295084531
  NPD
• Grand Lake Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 3, 2023.

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1760104756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 W CADDO ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740204201",
            "telephone_number": "580-747-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 W CADDO ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740204201",
            "telephone_number": "539-325-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MADISON",
        "middle_name": "BAILEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPCCANDIDATE10997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Lake Mental Health Center Inc
• Grand Lake Mental Health Center, Inc.
• Grand Lake Mental Health Center, Inc.
• Grand Lake Mental Health Center, Inc.
• Grand Lake Mental Health Center, Inc.
• Annamarie Guinn
• Josue Gutierrez, DMD
• Ashley Nicole Hambright
• Johnathan Derrell Hamilton Sr., BCBA
• Kiseki Hamilton

• All providers in Cleveland, OK
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.