MEDICARE: JOHN B GREEN LPC

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	101Y00000X	Counselor	14207	TX
2	104100000X	Social Worker	32696	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32696	OTHER	TX	SOCIAL WORKER
2	11624270	OTHER	TX	CAQH
3	14207	OTHER	TX	LPC

General Provider Information

NPI Number	:	1841340197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN B GREEN LPC

Provider Business Mailing Address
First Line	:	900 W MITCHELL ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-2537
Country	:	US
Telephone Number	:	469-644-9537
Fax Number	:	972-264-6758

Provider Business Practice Location Address
First Line	:	900 W MITCHELL ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-2537
Country	:	US
Telephone Number	:	469-644-9537
Fax Number	:	972-264-6758

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	09/11/2025

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Directions to “ JOHN B GREEN LPC” Practice Location

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