Diane Green, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

T-0125591 Issued in NM

Practice address

6611 Gulton CT NE
Albuquerque, NM 87109-4407

Phone

(505) 296-3965

Fax

(505) 323-9430

NPI assigned

Oct 16, 2009

Last updated

Oct 16, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Children's Treatment Center

  • Mental Illness Community Based Residential Treatment Facility
  • Albuquerque, NM
  • NPI 1750370847
  NPD (past)

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1942535422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 GULTON CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094407",
            "telephone_number": "505-296-3965",
            "fax_number": "505-323-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 GULTON CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094407",
            "telephone_number": "505-296-3965",
            "fax_number": "505-323-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DIANE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0125591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M1919",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chade B Green, PA-C
• David Phillip Green, M.D.
• Dawn Green
• Debra Green, MSN, C-FNP
• Debra Jane Green, RN
• Emily Green, AUD
• Faith Christine Green, LPN
• Kendall Bryce Green, M.D.
• Kerri D. Green, LMFT
• Miranda Astrid Green, MD

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.