1. Home
  2. Directory
  3. Michigan
  4. Ecorse
  5. Psychologist
  6. NPI Profile

LARESA GREEN
NPI 1841034295
Psychologist - Health Service in Ecorse, MI

Active since June 20, 2024
4317 11TH ST, ECORSE, MI 48229(313) 520-5311 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Laresa Green NPPES

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

LARESA GREEN (NPI 1841034295) is an individual health service provider in Ecorse, Michigan and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1841034295
Entity TypeIndividualFemale
Primary Taxonomy103TH0100X
Provider Legal NameLARESA GREEN
Location Address4317 11TH STEcorse, MI 48229-1162
Mailing Address4317 11th StEcorse, MI 48229-1162 · (313) 520-5311
Phone(313) 520-5311
Sole ProprietorNo
Enumeration DateJune 20, 2024
NPPES CertifiedJune 20, 2024
✔ NPI 1841034295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Health ServiceBehavioral Health & Social Service Providers
Taxonomy Code103TH0100X
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).
4317 11TH ST, Ecorse, MI 48229
Open in Google Maps ↗

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 Laresa Green's NPI number?

The NPI number for Laresa Green is 1841034295. It was assigned to this individual provider in the NPPES registry on June 20, 2024.

Where is Laresa Green located?

Laresa Green practices at 4317 11th St, Ecorse, MI 48229. The listed phone number is (313) 520-5311.

What is Laresa Green's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Health Service, with taxonomy code 103TH0100X.

When was this NPI record last updated?

The NPPES record for Laresa Green was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.