Greenbush Psychotherapy LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

GREENBUSH PSYCHOTHERAPY LLC

Practice address

541 S Randall Ave
Madison, WI 53715-1653

Phone

(608) 963-1380

NPI assigned

Oct 31, 2023

Organization subpart

No

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

Authorized official

Name

Jessica Marie BrooksNPI 1346457231

Title

Psychologist/Owner

Phone

(608) 963-1380

Specialties & licenses 5

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica M Brooks, PHD, CRC

  • Psychologist
  • Madison, WI
  • NPI 1346457231

  Counselor

  NPD Authorized official
• Katherine Balthazor, MS, LPC, CRC

  • Professional Counselor
  • Monona, WI
  • NPI 1649167594
  NPD

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1891568002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6580 MONONA DR # 1153",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537164032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S RANDALL AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151653",
            "telephone_number": "608-963-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBUSH PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "608-963-1380"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Green
• Rustin Dale Green, CRNA
• Sarah Joan Green, MS
• Zacoia Green
• Ross Stephen Greenberg, MD
• Joseph J Greene, ATC
• Kevin Jeffrey Greene, D.D.S.
• Lauren Ann Greene, M.D.
• Lily Jayne Catherine Greene, MD
• Susan Jeanette Greene, WHNP-BC, APNP

• Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.