Lacy Green

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8038-C Issued in AR

Practice address

1719 Merrill Dr
Little Rock, AR 72212-4009

Phone

(501) 663-2199

Fax

(501) 663-2234

NPI assigned

Jun 21, 2016

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1174973150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 FOREST HOME RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015320",
            "telephone_number": "866-972-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 MERRILL DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124009",
            "telephone_number": "501-663-2199",
            "fax_number": "501-663-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "8038-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerril Green, MD
• Jessica Green
• Joanna Patrice Green
• Judy Gail Green, MHPP CDA
• Kenneth L Green, QBHP
• Lisa Marie Green, LPC
• Lyndal Green, OTR/L
• Mariyah Green
• Matthew D Green, D.O.
• Megan Dunn-McDermott Green, MS, RD, LDN

• Clinical Social Worker in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.