MEDICARE: MRS. KARYN ANN GREEN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH7338	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447453444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARYN ANN GREEN LMHC

Provider Business Mailing Address
First Line	:	425 NW 6TH AVE
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-3629
Country	:	US
Telephone Number	:	561-662-9529
Fax Number	:

Provider Business Practice Location Address
First Line	:	16158 MILITARY TRL
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6502
Country	:	US
Telephone Number	:	561-637-2156
Fax Number	:	561-496-5064

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	07/08/2007

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