Greengate Neurobehavioral Health Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

GREENGATE NEUROBEHAVIORAL HEALTH INC

Practice address

19 N 5TH Ave
Beech Grove, IN 46107-1325

Phone

(937) 776-5012

NPI assigned

Apr 23, 2021

Last updated

Apr 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Theresa Greenlee, PSY.D.NPI 1467731836

Title

Owner

Phone

(937) 776-5012

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Greenlee, PSY.D.

  • Clinical Psychologist
  • Beech Grove, IN
  • NPI 1467731836
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1881276434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N 5TH AVE",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071325",
            "telephone_number": "937-776-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N 5TH AVE",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071325",
            "telephone_number": "937-776-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENGATE NEUROBEHAVIORAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "GREENLEE",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-776-5012",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franciscan VNS Home Care, Inc.
• Dakiyah Leann Gamble
• Alan Richard Gillespie, M.D.
• Anna Marie Goss, SLP
• Green Medcare LLC
• Theresa Greenlee, PSY.D.
• Danielle Greenwood, FNP
• Linda Gritzer, NP
• Angela B. Hackman, MD
• Krysten Raeanne Harlan, PHARMD

• Clinical Psychologist in Beech Grove, IN
• Providers in Beech Grove, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.