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Contact Information

KIMBERLEY A GREEN, PH.D., HSPP
1 UNIVERSITY BLVD
COMMUNITY PSYCHOLOGICAL SERVICE, 232 STADLER HALL
SAINT LOUIS, MO63121-4400
 Phone: 314-516-5824
 Fax: 314-516-5347
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Service

103TH0100X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KIMBERLEY A GREEN · (Female)

NPI Number 1821084476
Status Active
Credentials PH.D., HSPP
Entity Individual
Enumeration date 09/20/2005
Last updated 11/26/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 20040602
  • IN Medicaid 100167180A
  • Other 7453298 AETNA
  • Other 000000533237 ANTHEM BC/BS
  • Other 06010200 MAGELLAN HEALTH SERVICES
  • Other 084081 SIHO - SOUTHEASTERN INDIANA HEALTH ORGANIZATION
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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