DR. KELLY GREEN (NPI# 1093295263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093295263 |
| Entity Type | Individual |
| Full Name | DR. KELLY GREEN |
| Credential | PH.D. |
| Practice Address |
3535 Market St Ste 3037 Philadelphia PA 19104-3313 |
| Mailing Address |
712 S Clifton St Philadelphia PA 19147-1978 |
| Practice Telephone | 2157467337 |
| Mailing Telephone | 8324341719 |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013533728 | Kelly M Green | Dietitian, Registered | 12201 Stanfield Ct, Bowie, MD 20720-4439 | 2020-06-18 |
| 1558802975 | Kelly Green | Counselor | 15336 Devonshire St Unit 6, Mission Hills, CA 91345-2755 | 2017-03-18 |
| 1255887386 | Kelly Green | Physician Assistant | 1237 Shirehall Park Ln, Wake Forest, NC 27587-0601 | 2016-08-29 |
| 1730589565 | Kelly Green | Physical Therapist | 3014 Boaires Ln, Louisville, KY 40220-2428 | 2014-08-29 |
| 1467685107 | Kelly Elizabeth Green | Psychologist | 5524 Bee Caves Road, Suite G-2, Austin, TX 78746 | 2009-08-28 |
| 1437249547 | Kelly Ray Green | Pediatrics | 19087b Greeno Rd, Fairhope, AL 36532-3899 | 2006-10-13 |
| 1801803572 | Kelly Elaine Green | Social Worker | 1604 S W S Young Dr, Killeen, TX 76543-5003 | 2006-08-02 |
| 1649230947 | Kelly Patrick Green | Optometrist | 7437 Burnet Rd, Austin, TX 78757-2244 | 2006-03-23 |
| 1346804721 | Kelly R Green | Case Manager/Care Coordinator | 2540 Billingsley Rd, Columbus, OH 43235-1990 | 2019-05-01 |
| 1235646274 | Kelly Michelle Green | Registered Nurse | 2409 Homer Clayton Dr, Guntersville, AL 35976-2207 | 2017-12-29 |
| Street Address |
3535 MARKET ST STE 3037 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-3313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578937 | Margaret Edwards | Psychologist | 110 S 20th St Ste 206, Philadelphia, PA 19103-4486 | 2020-11-03 |
| 1699374843 | Elizabeth Ann Johnson | Psychologist | 3640 Stanton St Apt 107, Philadelphia, PA 19129-1683 | 2020-10-20 |
| 1689272577 | Katherine Piselli | Psychologist | 3401 Market St Ofc 3216, Philadelphia, PA 19104-3318 | 2020-10-13 |
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1659980621 | Corinne Masur | Psychologist | 1601 Walnut St Ste 1408, Philadelphia, PA 19102-2909 | 2020-07-27 |
| 1730798067 | Amanda Marie Large | Psychologist | 1516 N 5th St Unit 401, Philadelphia, PA 19122-3679 | 2020-07-22 |
| 1295355543 | Jennifer Ann Engelhardt | Psychologist | 8201 Henry Ave Apt Q15, Philadelphia, PA 19128-2248 | 2020-04-16 |
| 1336778315 | Carly Mirit Gerbi | Psychologist | 2227 Delancey Pl, Philadelphia, PA 19103-6549 | 2020-04-02 |
| 1811530512 | Tower Drexel Academic Medical Group LLC | Psychologist | 1427 Vine St Fl 1, Philadelphia, PA 19102-1031 | 2019-10-25 |
| 1003459702 | Tower Drexel Academic Medical Group LLC | Psychologist | 4700 Wissahickon Ave Ste C102, Philadelphia, PA 19144-4248 | 2019-10-25 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.