Jan Maureen Green, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00819 Issued in IA

Practice address

215 6TH Ave S
Suite 25
Clinton, IA 52732-4338

Phone

(563) 242-9210

Fax

(563) 243-0730

NPI assigned

Feb 7, 2007

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healing Place, L.L.C.Group PAC ID 5799930475, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healing Place, L.L.C.

  • Psychiatric Residential Treatment Facility
  • Clinton, IA
  • NPI 1558536524
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922148279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 6TH AVE S",
            "address_2": "SUITE 25",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324338",
            "telephone_number": "563-242-9210",
            "fax_number": "563-243-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 6TH AVE S",
            "address_2": "SUITE 25",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324338",
            "telephone_number": "563-242-9210",
            "fax_number": "563-243-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAN",
        "middle_name": "MAUREEN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Amber Michelle Gjerstad
• Gabriel Robert Gluba, LMSW, MCJ, CADC
• Robert Lucas Goetz, DC
• Terrance J Goodell, LMHC
• Janet R Graf
• Kaitlyn Green
• Michelle Jo Green, MSW, LSW
• Deborah K Greve, RNC NURSE
• Tricia Lee Grimes, PROVIDER
• Kimberly A Grimm, OTR/L

• Mental Health Counselor in Clinton, IA
• Providers in Clinton, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.