KELLY KATHLEEN GREENE (NPI# 1508810318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508810318 |
| Entity Type | Individual |
| Full Name | KELLY KATHLEEN GREENE |
| Credential | PSY.D. |
| Practice Address |
701 Us Highway 31 S Traverse City MI 49685-8016 |
| Practice Telephone | 9894972500 |
| Mailing Telephone | 9894972500 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 6301011602 | MI | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 6301011602 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1508810318 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1050 Silver Dr, Traverse City, MI 496845749 | 2319472255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346623154 | Kelly L Greene | Registered Nurse | 1901 E Wausau Ave, Wausau, WI 54403-3158 | 2015-06-30 |
| 1417311549 | Kelly Maureen Greene | Counselor | 122 Business Park Dr Ste 1, Utica, NY 13502 | 2016-04-05 |
| 1962873356 | Kelly Greene | Hearing Instrument Specialist | 5540 Pga Blvd, Suite 102, Palm Beach Gardens, FL 33418-3987 | 2015-10-12 |
| 1609116102 | Kelly Page Greene | Registered Nurse | 405 W Washington St, Dillon, SC 29536-2855 | 2013-02-20 |
| 1073702742 | Kelly N Greene | Nurse Practitioner | 1930 Alcoa Hwy, Suite 145, Knoxville, TN 37920-1500 | 2007-10-18 |
| 1194920793 | Kelly M Greene | Occupational Therapist | 182 North St, Auburn, NY 13021-1811 | 2007-06-15 |
| 1790857340 | Kelly E Greene | Internal Medicine | 15 W Dry Creek Cir, Littleton, CO 80120-4427 | 2006-11-15 |
| 1972674679 | Kelly Ann Greene V | Case Manager/Care Coordinator | 500 W Foster Rd, Santa Maria, CA 93455-3620 | 2006-11-13 |
| Street Address |
701 US HIGHWAY 31 S |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49685-8016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811931918 | Saginaw Vamc | Clinic/Center | 701 Us Highway 31 S, Traverse City, MI 49685-8016 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508379496 | Alexandra Hull | Physical Therapist | 4177 Village Park Dr., Suite B, Traverse City, MI 49685 | 2017-11-14 |
| 1215452164 | Holli Home Health Care, LLC | Home Health | 2062 North Us-31 South, Suite A, Traverse City, MI 49685 | 2017-08-11 |
| 1013307867 | Culver Senior Living, Inc. | Foster Care Agency | 1745 N West Silver Lake Rd, Traverse City, MI 49685 | 2015-02-02 |
| 1295154656 | Mark Langlois Jr. | Family Medicine | 5191 Rosewood Dr, Traverse City, MI 49685 | 2014-04-14 |
| 1679844849 | Crystal Lake Clinic, PC | Family Medicine | 5191 Rosewood Dr, Traverse City, MI 49685 | 2012-01-20 |
| 1487103610 | Laura Christine Field | Social Worker | 6325 Cherry Blossom Dr, Traverse City, MI 49685-5000 | 2016-09-29 |
| 1730132879 | Franklin Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 404 W Commerce Dr, Suite B, Traverse City, MI 49685-5854 | 2006-05-18 |
| 1588281695 | Carly Overmire | Behavior Technician | 3000 Arborvitae Dr Apt 11, Traverse City, MI 49685-6708 | 2020-07-06 |
| 1134576853 | Paula Mclane | Registered Nurse | 2400 W Crown Dr Unit 1, Traverse City, MI 49685-6715 | 2016-05-23 |
| 1376927756 | Crystal Lake Clinic P.C. | Family Medicine | 4025 Chums Village Dr, Traverse City, MI 49685-6992 | 2015-07-15 |
| Find all providers in zip 49685 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003950536 | Kelly K Greene PC | Clinical Neuropsychologist | 921 W 11th St Ste 1w, Traverse City, MI 49684-3002 | 2007-02-17 |
| 1023352747 | Pintar Psychological Services, PC | Clinical Neuropsychologist | 12719 S West Bay Shore Dr, Suite #9, Traverse City, MI 49684-5489 | 2012-11-19 |
| 1932467248 | Jamie Pintar | Clinical Neuropsychologist | 12719 S West Bay Shore Dr, Suite #9, Traverse City, MI 49684-5489 | 2012-04-25 |
| 1124189642 | Paul Callaghan | Clinical Neuropsychologist | 3537 W Front St, Ste F, Traverse City, MI 49684-7943 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265046098 | Axon Psychology Group, PC | Clinical Neuropsychologist | 1377 Stonecreek Ct, Saint Joseph, MI 49085-9795 | 2020-08-31 |
| 1548814965 | Emily Nicole Robinett-ferrara | Clinical Neuropsychologist | 14050 Kingston St, Oak Park, MI 48237-1140 | 2019-07-25 |
| 1649782244 | Matthew Kadrich | Clinical Neuropsychologist | 3334 Rochester Rd # 205, Troy, MI 48083-5426 | 2017-11-04 |
| 1992237176 | Lauren Marie Golla | Clinical Neuropsychologist | 111 E Court St Ste 1b, Flint, MI 48502-1649 | 2017-03-28 |
| 1750839783 | Ace Psychological Consultants LLC | Clinical Neuropsychologist | 1920 Livernois Rd Ste D, Troy, MI 48083-1770 | 2016-09-20 |
| 1922556406 | Kenya Hameed | Clinical Neuropsychologist | 111 East Court St, Suite 1b-1, Flint, MI 48502 | 2016-09-14 |
| 1841609369 | Crystal Young | Clinical Neuropsychologist | 1550 E Beltline Ave Se, Suite 340, Grand Rapids, MI 49506-4301 | 2014-08-08 |
| 1497165146 | Woojin Song | Clinical Neuropsychologist | 2101 Commonwealth Blvd Ste C, Ann Arbor, MI 48105-2969 | 2014-05-03 |
| 1831516152 | Ira Lourie, Psy.d., Pllc | Clinical Neuropsychologist | 30051 High Valley Rd, Farmington Hills, MI 48331-2144 | 2014-03-25 |
| 1306272042 | Erin Mark | Clinical Neuropsychologist | 2010 Hogback Rd Ste 6g, Ann Arbor, MI 48105-8800 | 2013-09-25 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49685 |
Please comment or provide details below to improve the information on KELLY KATHLEEN GREENE.
| 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.