DR. SYDJEA M GREEN PHD
NPI 1750004248
Psychologist in Southlake, TX

Active since September 21, 2022PECOS Enrolled
1230 N KIMBALL AVE STE 130, SOUTHLAKE, TX 76092(833) 667-7924(817) 755-0945 Get Directions Write a Review

NPPES record last updated: September 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sydjea M Green Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SYDJEA M GREEN PHD (NPI 1750004248) is an individual psychologist in Southlake, Texas, licensed in Texas (39576) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750004248
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SYDJEA M GREENCredential: PHD
Location Address1230 N KIMBALL AVE STE 130Southlake, TX 76092-4707
Mailing Address126 Floyd StBrentwood, NY 11717-2646 · (631) 336-0695
Fax(817) 755-0945
Sole ProprietorYes
Enumeration DateSeptember 21, 2022
NPPES CertifiedSeptember 21, 2022
NPI 1750004248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in TX · 39576
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1230 N KIMBALL AVE STE 130, Southlake, TX 76092

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Sydjea M Green Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
1230 N KIMBALL AVE STE 130
SOUTHLAKE, TX 76092
Nurse Practitioner (Psychiatric/Mental Health)
1230 N KIMBALL AVE STE 130
SOUTHLAKE, TX 76092
Surgery
1230 N KIMBALL AVE STE 130
SOUTHLAKE, TX 76092
Clinic/Center
1230 N KIMBALL AVE STE 130
SOUTHLAKE, TX 76092
Nurse Practitioner (Psychiatric/Mental Health)
1230 N KIMBALL AVE STE 130
SOUTHLAKE, TX 76092

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sydjea Green's NPI number?

The NPI number for Sydjea Green is 1750004248. It was assigned to this individual provider in the NPPES registry on September 21, 2022.

Where is Sydjea Green located?

Sydjea Green practices at 1230 N Kimball Ave Ste 130, Southlake, TX 76092. The listed phone number is (833) 667-7924.

What is Sydjea Green's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Sydjea Green enrolled in Medicare?

Yes. Sydjea Green is registered in the Medicare PECOS enrollment system.

What insurance does Sydjea Green accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Sydjea Green as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sydjea Green was last updated on September 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.