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Provider Information for 1225084304


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Ms. PAULA DANETTE GREEN MS, LCPC


Sex: Female

NPI: 1225084304
Last Updated: 2025-03-14
Certification Date: 2025-03-14

Details

NameValue
NPI1225084304
Enumeration Date2006-05-26
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 127 MESA VERDE ST STE A
SANTA FE, NM 87501-1729
United States

Phone: 208-283-6365 | Fax:
 
Primary Practice Address 127 MESA VERDE ST STE A
SANTA FE, NM 87501-1729
United States

Phone: 208-283-6365 | Fax:
 
Secondary Practice Address(es)

250 FILLMORE ST UNIT 150
DENVER, CO 80206-5001
United States

Phone: 415-424-4266 | Fax:415-520-6633
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental HealthIDLCPC-4139
Yes 101YP2500X - Counselor - ProfessionalCOLPC0021417