UNICKA MARE GREEN


Address: 5651 S Perry Ave, Chicago, IL 60621-4019
Phone: 4142368489

UNICKA MARE GREEN (NPI# 1548886302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548886302
Entity Type Individual
Full Name UNICKA MARE GREEN
Practice Address 5651 S Perry Ave
Chicago
IL 60621-4019
Mailing Address 5744 S Ada St
Chicago
IL 60636-1832
Practice Telephone 4142368489
Mailing Telephone 7739603620
Enumeration Date 2020-06-17
Last Update Date 2020-06-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TH0100X Psychologist
Specialization: Health Service
IL Behavioral Health & Social Service Providers

Office Location

Street Address 5651 S PERRY AVE
City CHICAGO
State IL
Zip Code 60621-4019

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Taxonomy Information

Taxonomy Code 103TH0100X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Health Service

Taxonomy Definition

A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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Competitor

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City CHICAGO
Zip Code 60621

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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