Justin O Green, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0311042 Issued in AR

Practice address

1022 Heatherdown
Mountain Home, AR 72653-5015

Phone

(870) 232-1823

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Bokker Enterprises, Inc.

  dba Hope Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Highland, AR
  • NPI 1508040262
  NPD (past)
• Bokker Enterprises, Inc.

  dba Hope Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Salem, AR
  • NPI 1821564436
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1881613503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 HEATHERDOWN",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726535015",
            "telephone_number": "870-232-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 HEATHERDOWN",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726535015",
            "telephone_number": "870-232-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JUSTIN",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0311042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS PROVIDER NUMBER",
            "identifier": "5S755",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Abounds
• Daniel Grace
• Gracon Inc (Home Bound Home Health)
• Gracon, Inc. (Home Bound Medical)
• Franklin John Gray Jr., M.D.
• Sydney Desira Greene, DPT
• Susan Gregory
• Teresa Mary Frances Grigg, BSN, RN
• William Spencer Grigg, D.O.
• Nadah Griggs, MHPP

• Professional Counselor in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.