Active NPI
Jo Baxter Green, PHD
- Mental Health Counselor
- Palestine, TX
National Provider Identifier
1811101405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 16370
- Practice address
- 516 N Sycamore St
Palestine, TX 75801-2840 - Phone
- (903) 723-7706
- Fax
- (903) 723-7716
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 16370 | TX | Primary |
Addresses
Primary practice location
516 N Sycamore St
Palestine, TX 75801-2840
Mailing address
PO Box 2116
Palestine, TX 75802-2116
Phone (903) 723-7706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1712572 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16370 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1811101405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2116",
"city": "PALESTINE",
"state": "TX",
"postal_code": "758022116",
"telephone_number": "903-723-7706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 N SYCAMORE ST",
"city": "PALESTINE",
"state": "TX",
"postal_code": "758012840",
"telephone_number": "903-723-7706",
"fax_number": "903-723-7716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JO",
"middle_name": "BAXTER",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "16370",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1712572",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palestine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.