Crystal B Green-Randle

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC7361 Issued in MD

Practice address

1031 Ingleside Ave
Catonsville, MD 21228-1318

Phone

(443) 763-3718

Fax

(410) 744-7309

NPI assigned

Oct 21, 2014

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

Medicare fee-for-service enrollment

Enrolled in MD

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

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.

• Gallery of Minds

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1114566973
  NPD Authorized official

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1982008835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 INGLESIDE AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281318",
            "telephone_number": "443-763-3718",
            "fax_number": "410-744-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 INGLESIDE AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281318",
            "telephone_number": "443-763-3718",
            "fax_number": "410-744-7309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4015 W Franklin St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212292916",
            "country_code": "US",
            "telephone_number": "443-415-5075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN-RANDLE",
        "first_name": "CRYSTAL",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2020-12-02",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC7361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Allegany Counseling
• Greater Allegany Counseling
• Greater Maryland Pain Management, LLC
• John A Greco, PA-C
• Rosalind Green Barnes, LCSWC
• Sarah Green, LCPC
• Shannon Green, RD CDE CSR LDN
• Alyssa Gregor, LMSW
• Brandi Grier, LGPC
• Hope U Griffin, MD

• Professional Counselor in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.