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NPI Code Detail

MEDICARE: GREEN COUNSELING SERVICES PLLC

MEDICARE: GREEN COUNSELING SERVICES PLLC
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
1103TC1900XCounseling Psychologist01011IA
2101YM0800XMental Health Counselor089407IA

General Provider Information

NPI Number : 1528564762
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREEN COUNSELING SERVICES PLLC
Provider Business Mailing Address
First Line : 2025 MEHAFFEY BRIDGE RD NE
Second Line :
City : SOLON
State : IA
Zip : 52333-9218
Country : US
Telephone Number : 515-450-8913
Fax Number :
Provider Business Practice Location Address
First Line : 2240 9TH ST
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-1575
Country : US
Telephone Number : 515-450-8913
Fax Number :
Authorized Official
Title or Position : PSYCHOLOGIST
Name : DR. MELINDA ANN GREEN
Credential : PHD
Telephone Number : 515-450-8913
Provider Enumeration Date : 04/05/2018
Last Update Date : 02/18/2025

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