Individual provider Active NPI

Kelly Elizabeth Greene, LCSW, LCADC

  • Clinical Social Worker
  • Fair Haven, NJ
National Provider Identifier
1083338404
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06470000 Issued in NJ
Practice address
154 Lexington Ave
Fair Haven, NJ 07704-3040
Phone
(732) 759-7358
NPI assigned
Sep 29, 2022
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06470000 NJ Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00348800 NJ

Addresses

Primary practice location

154 Lexington Ave
Fair Haven, NJ 07704-3040

Mailing address

154 Lexington Ave
Fair Haven, NJ 07704-3040
Phone (732) 759-7358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37LC00348800NJMDAddiction (Substance Use Disorder) Counselor
44SC06470000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Clarity LLC Clinical PastSince Oct 1, 2022 Accepting new patients
Inner Clarity Counseling Clinical PastSince Oct 1, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1083338404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 LEXINGTON AVE",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043040",
            "telephone_number": "732-759-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 LEXINGTON AVE",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043040",
            "telephone_number": "732-759-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06470000",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00348800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Haven, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.