MEDICARE: REUVEN GREEN BT

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1851250526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REUVEN GREEN BT

Provider Business Mailing Address
First Line	:	3401 BLANCHE AVE
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2129
Country	:	US
Telephone Number	:	216-600-6315
Fax Number	:	385-550-7329

Provider Business Practice Location Address
First Line	:	5444 S GREEN ST STE B
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84123-5632
Country	:	US
Telephone Number	:	385-550-3500
Fax Number	:	385-550-7329

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ REUVEN GREEN BT” Practice Location

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