Brenden Eugene Green, LPCC, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0181451 Issued in NM

Practice address

2875 Tina Ave Ste 106
Missoula, MT 59808-1582

Phone

(406) 552-3587

NPI assigned

Feb 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Mr. Brenden Eugene Dix Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• A Guiding Path, LLC

  • Professional Counselor
  • Missoula, MT
  • NPI 1235586967
  NPD Authorized official

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1780008342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 LONE MOOSE CT",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "598336005",
            "telephone_number": "505-977-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 TINA AVE STE 106",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081582",
            "telephone_number": "406-552-3587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6315 Lone Moose Ct",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "MT",
            "postal_code": "598336005",
            "country_code": "US",
            "telephone_number": "505-977-5376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRENDEN",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "LPCC, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "T-0164301",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0013284",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "BBH-LCPC-LIC-43089",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0181451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780008342",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0686766",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDEN",
            "last_name": "DIX",
            "middle_name": "EUGENE",
            "prefix": "MR.",
            "credential": "LPCC, LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gordon Matthew Gray, M.D.
• Stacy Jane Gray
• Great Divide Physical Therapy LLC
• Greater Good Health PC Inc
• Greater Good Health PC, Inc.
• Carla M Green, LMT
• Jeffrey Paul Green, DDS
• Joshua Green, D.D.S.
• Kristin Kathleen Green, DPT, OCS
• Robyn Kay Green, PA-C

• Professional Counselor in Missoula, MT
• Providers in Missoula, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.