Individual provider Active NPI

William C Green, LCSW

  • Clinical Social Worker
  • Shepherdsville, KY
National Provider Identifier
1073539888
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0642 Issued in KY
Practice address
1729A Highway 44 E
Shepherdsville, KY 40165
Phone
(502) 543-4766
NPI assigned
Jul 14, 2006
Last updated
Jul 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0642 KY Primary

Addresses

Primary practice location

1729A Highway 44 E
Shepherdsville, KY 40165

Mailing address

3224 Hurstbourne Springs Dr
Louisville, KY 40220
Phone (502) 493-2827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000882 KY Practitioner - Clinical Social Worker 9133025067 Practice locations: Shepherdsville, KY; Louisville, KY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2303 Hurstbourne Village Dr
Suite 1100
Louisville, KY 40299-1830
Phone (502) 493-2827

3224 Hurstbourne Springs Dr
Louisville, KY 40220-5867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0642KYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1073539888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 HURSTBOURNE SPRINGS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40220",
            "telephone_number": "502-493-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729A HIGHWAY 44 E",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "40165",
            "telephone_number": "502-543-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "0642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

Verify at the official NPI Registry.