MRS. CRYSTAL LOUISE GREEN (NPI# 1114535150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114535150 |
| Entity Type | Individual |
| Full Name | MRS. CRYSTAL LOUISE GREEN |
| Other Name | MS. CRYSTAL LOUISE BURNS |
| Practice Address |
307 W Cota St Shelton WA 98584-2265 |
| Mailing Address |
19206 21st St Sw Lakebay WA 98349-9280 |
| Practice Telephone | 3608392822 |
| Practice Fax Number | 3608392822 |
| Mailing Telephone | 1253292888 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 100000034753 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639780661 | Crystal Renay Green | Technician | 99 Croft Ln, Madison, WV 25130-8501 | 2020-08-13 |
| 1568942654 | Crystal Green | Licensed Practical Nurse | 997 Shelburne Dr, Franklin Square, NY 11010-1011 | 2018-08-17 |
| 1215467741 | Crystal Ann Green | Nurse Practitioner | 246 Ky-979, Harold, KY 41635 | 2017-06-18 |
| 1639508385 | Crystal Green | Technician | 601 N Mechanic St Ste 302, Franklin, VA 23851-1455 | 2013-11-04 |
| 1255944997 | Crystal Marie Green | Social Worker | 7200 Bancroft Ave Ste 125a, Oakland, CA 94605-2457 | 2020-08-24 |
| 1215574967 | Crystal Green | Developmental Therapist | 345a Greenwood St, Worcester, MA 01607-1753 | 2019-12-02 |
| 1437620093 | Crystal Nicole Green | Registered Nurse | 998 Crooked Hill Rd, Brentwood, NY 11717-1019 | 2018-12-07 |
| 1558874479 | Crystal Lacey Green | Counselor | 1 Elizabeth Pl, Dayton, OH 45417-3445 | 2017-11-14 |
| 1225540909 | Crystal Green | Case Manager/Care Coordinator | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2017-11-02 |
| 1407195076 | Crystal Michelle Green | Home Health Aide | 11511 Brigit Ct, Bowie, MD 20720-4420 | 2013-02-02 |
| Street Address |
307 W COTA ST |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933105 | Joshua Ireland | Psychologist | 307 W Cota St, Shelton, WA 98584-2265 | 2019-10-08 |
| 1528668787 | Ricardo De Jesus Funes | Social Worker | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-27 |
| 1841899713 | Mary Katherine Twidwell | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-22 |
| 1871191676 | Samantha Lynn Thompson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-14 |
| 1316559131 | Kerry Rose Johnson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-21 |
| 1013529122 | Jennifer A Sagen | Registered Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1629680731 | Akashia Milsap | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1457963571 | Shane Micheal Taylor | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1740890318 | Eric William Rehwaldt | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| 1013527654 | Tracy Lynn Wright | Licensed Practical Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1619594330 | Brenna Woslum | Counselor | 1433 Mason St, Shelton, WA 98584-1167 | 2020-06-29 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1437686458 | Michael Brooks | Counselor | 601 W Franklin St Ste A, Shelton, WA 98584-3518 | 2017-05-22 |
| 1053701854 | Rites of Passage Nw LLC | Counselor | 142 E Strong Rd, Shelton, WA 98584-8861 | 2015-01-31 |
| 1740606334 | Patricia Helm | Counselor | 574 E Pointes Dr W, Shelton, WA 98584-9419 | 2014-03-07 |
| 1578851911 | Kelly Gale Kimbel | Counselor | 428 W Birch St Ste 11, Shelton, WA 98584-1700 | 2011-07-19 |
| 1073821575 | Randall Fred Beaver | Counselor | 235 S 3rd St, Shelton, WA 98584-2255 | 2010-09-17 |
| 1770810236 | Nancy C. Nolda | Counselor | 730 E Burgundy Rd, Shelton, WA 98584-9430 | 2009-11-04 |
| 1366679672 | Rachel Lynn Johnson | Counselor | 117 N 8th St Ste 100, Shelton, WA 98584 | 2009-06-12 |
| Find all providers in SHELTON | ||||
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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.