Kelly Kathleen Greene, PSYD is a 
Clinical Neuropsychologist based in Traverse City, Michigan. Kelly Kathleen Greene is licensed to practice in Michigan (license number 6301011602) and her current practice location is 
701 Us Highway 31 S, Traverse City, Michigan. She can be reached at her office (for appointments etc.) via phone at 
(989) 497-2500.
NPI number for Kelly Kathleen Greene is 1508810318 and her current mailing address is 701 Us Highway 31 S, Traverse City, Michigan. She 
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1508810318.
				
				
				
				
				
		 
		
		 
Healthcare Provider's Profile
		
			
			
			| Full Name | Kelly Kathleen Greene | 
|---|
| Gender | Female | 
|---|
| Speciality | Clinical Neuropsychologist | 
|---|
| Location | 701 Us Highway 31 S, Traverse City, Michigan | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1508810318
 - Provider Enumeration Date: 05/19/2006
 - Last Update Date: 02/28/2020
 			
			
			 
		 
		 
Medical Identifiers
		Medical identifiers for Kelly Kathleen Greene such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
		| 1508810318 | NPI | - | NPPES | 
| 1508810318 | Medicaid | MI |  | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
		| 103T00000X | Psychologist  | 6301011602 (Michigan) | Secondary | 
| 103G00000X | Clinical Neuropsychologist  | 6301011602 (Michigan) | Primary | 
		
		
			
			
			
		
		
		 
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Kathleen Greene is 
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
		
		
 
Mailing Address and Practice Location
		
		| Mailing Address | Practice Location Address | 
		Kelly Kathleen Greene, PSYD 701 Us Highway 31 S, Traverse City, MI 49685-8016 Ph: (989) 497-2500 | Kelly Kathleen Greene, PSYD 701 Us Highway 31 S, Traverse City, MI 49685-8016 Ph: (989) 497-2500 | 
		
		 
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