Roderica Green, M.A., M.P.H., C.A.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1431 N Claremont Ave
2ND Floor Pavillion
Chicago, IL 60622-1702

Phone

(312) 491-7268

Fax

(312) 491-5453

NPI assigned

Aug 17, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1902186315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE",
            "address_2": "2ND FLOOR PAVILLION",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE",
            "address_2": "2ND FLOOR PAVILLION",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-7268",
            "fax_number": "312-491-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RODERICA",
        "credential": "M.A., M.P.H., C.A.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "GREEN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Patricia Lynn Green, APN
• Renee Victoria Green, LCSW
• Richard Green, M.D.
• Richard Green, MD
• Rikkell Green, M.S.W
• Ross Wayne Green, D.P.M.
• Sara Nicole Green, OTD, OTR/L
• Sarah Green, LCSW
• Savannah Green
• Sean Loren Green, LCSW

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.