Kelli Ann Greene, MSW, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

99105360A Issued in IN

Practice address

115 Farabee Dr N Ste B-2
Lafayette, IN 47905-5913

Phone

(765) 426-8230

NPI assigned

Aug 3, 2021

Last updated

Aug 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Winding Roads Counseling LLC

  • Mental Health Counselor
  • Franklin, IN
  • NPI 1710614235
  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1912671967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FARABEE DR N STE B-2",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055913",
            "telephone_number": "765-426-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FARABEE DR N STE B-2",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055913",
            "telephone_number": "765-426-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99105360A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cindy Sue Green-Smith, LCSW
• Adriana Green, FNP-BC
• Linda C Gregor, PT
• Beth Gretencord, CPSP
• Misty Gail Gretencord, D.D.S
• Emma Greves, RBT
• Karla Grewe, CST, CFA

• Mental Health Counselor in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.