Individual provider · Type 1 NPI

Jefferson Robert Green

Counselor · Wilmington, NC

NPI number 1508709122 Active

Practice location

3205 Randall Pkwy Ste 217
Wilmington, NC 28403-2569

Call (910) 877-1598 Map

Mailing address

5306 Autumn Dr
Wilmington, NC 28409-5702

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XP023659 (NC)

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1508709122

Jefferson Robert Green's National Provider Identifier is 1508709122, issued on Apr 9, 2026. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Wilmington, NC. The record was last updated on Apr 9, 2026.