Phyllis Green

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701013085 Issued in VA

Practice address

2780 SW 37TH Ave Ste 206
Coconut Grove, FL 33133-2740

Phone

(305) 646-0112

NPI assigned

Mar 2, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1902308240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 SW 37TH AVE STE 206",
            "city": "COCONUT GROVE",
            "state": "FL",
            "postal_code": "331332740",
            "telephone_number": "305-646-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SW 37TH AVE STE 206",
            "city": "COCONUT GROVE",
            "state": "FL",
            "postal_code": "331332740",
            "telephone_number": "305-646-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "PHYLLIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701013085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oriett Garay, PSYCHOLOGY MS
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• Sabine Gempel, DPT, PT
• Goldenberg Candid Florida, Professional Association
• Grand Living 21, LLC
• Martin Allen Grossman, D.C.
• Grove Med Plus Inc
• Altagrace Lindsay Gustave
• Alejandra Daniella Guzman, PA-C
• Leah Guzman, ATR-BC

• Mental Health Counselor in Coconut Grove, FL
• Providers in Coconut Grove, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.