Individual provider · Type 1 NPI
Jacqualyn F. Green, PhD
Marriage & Family Therapist · Indianapolis, IN
Practice location
4755 Kingsway Dr Ste 308
Indianapolis, IN 46205-1571
Fax (317) 863-1414
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | 34000712A (IN) |
| Marriage & Family Therapist Primary | 106H00000X | 35000324A (IN) |
Marriage & Family Therapist: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats ment…
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About NPI 1093861932
Jacqualyn F. Green, PhD's National Provider Identifier is 1093861932, issued on Jan 25, 2007. The primary taxonomy on file is Marriage & Family Therapist (106H00000X), and the practice location is in Indianapolis, IN. The record was last updated on Sep 11, 2025.