MEDICARE: LATIA CHANELL GREEN M.ED, LPC, LCDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	14060	TX
2	101YP2500X	Professional Counselor	79877	TX

General Provider Information

NPI Number	:	1881209633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATIA CHANELL GREEN M.ED, LPC, LCDC

Provider Business Mailing Address
First Line	:	4204 49TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79413-3722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6313 13TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79416-5940
Country	:	US
Telephone Number	:	806-441-3892
Fax Number	:

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

Provider Enumeration Date	:	09/09/2020
Last Update Date	:	12/01/2022

Similar Medicare Providers

1588543250 — ARBORETUM CLINICAL, LLC
Practice Location Address:

6901 QUAKER AVE STE 300
LUBBOCK, TX
79413-5940

Practice Phone: 617-465-0969
Practice Fax:

1073776860 — MICROGENDX, LLC
Practice Location Address:

6901 QUAKER AVE STE 200
LUBBOCK, TX
79413-5940

Practice Phone: 806-776-2611
Practice Fax: 806-749-7886

1497689798 — XIA RIOS RN
Practice Location Address:

6218 18TH ST
LUBBOCK, TX
79416-6145

Practice Phone: 806-702-0319
Practice Fax:

1104750330 — MRS. KELSEY NICOLE BEAN FNP-C
Practice Location Address:

611 N FRANKFORD AVE
LUBBOCK, TX
79416-1545

Practice Phone: 806-725-5480
Practice Fax:

1447479787 — JASON RAMSEY MD
Practice Location Address:

301 UTICA AVE
LUBBOCK, TX
79416-3111

Practice Phone: 806-797-4985
Practice Fax: 806-792-8588

1922001775 — LUBBOCK HEART HOSPITAL, LLC
Practice Location Address:

4810 NORTH LOOP 289
LUBBOCK, TX
79416-3025

Practice Phone: 806-687-7777
Practice Fax: 806-472-3763

Directions to “ LATIA CHANELL GREEN M.ED, LPC, LCDC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.