MEDICARE: LARRY GREEN LMFT

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	106H00000X	Marriage & Family Therapist	MT2733	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MT2733	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619281979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY GREEN LMFT

Provider Business Mailing Address
First Line	:	PO BOX 36
Second Line	:
City	:	ARCHER
State	:	FL
Zip	:	32618-0036
Country	:	US
Telephone Number	:	352-448-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	7106 NW 11TH PL
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32605-3157
Country	:	US
Telephone Number	:	352-448-9120
Fax Number	:

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

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	06/02/2026

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Directions to “ LARRY GREEN LMFT” Practice Location

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