Katherine Ann Green, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH9789 Issued in FL

Practice address

3733 University Blvd W Ste 203
Jacksonville, FL 32217-2152

Phone

(904) 536-8589

NPI assigned

Mar 14, 2016

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)

Not 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.

• Keep Going Counseling, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1063228955

  Mental Health

  NPD Authorized official
• Authentic Self Counseling of Jacksonville, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1407400591

  Mental Health

  NPD
• Gauler & Associates, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
  • NPI 1730405002
  NPD (past)

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1962863340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 KIRKPATRICK CIR UNIT 11",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322100214",
            "fax_number": "352-244-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 UNIVERSITY BLVD W STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172152",
            "telephone_number": "904-536-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Alexandra Green
• Jeffrey Michael Green, PA-C
• Jessika Rebekkah Green
• Jodi S Green, M.A., CCC-A, FAAA
• Katerina Jane Green, MB BCH BAO
• Kayla Green
• Kiara Green
• Latifah Latrelle Green, CMA
• Latonya Denise Green, APRN
• Lauren Green

• All providers in Jacksonville, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.