Amy N Greene, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113821 Issued in MA

Practice address

10 Willard LN
Marblehead, MA 01945-1559

Phone

(978) 423-4818

Fax

(781) 631-0285

NPI assigned

Nov 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Northeast Behavioral Health Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly, MA
  • NPI 1154302586

  MA

  Medicare reassignment NPD
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  NPD (past)

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1194907253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WILLARD LN",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451559",
            "telephone_number": "978-423-4818",
            "fax_number": "781-631-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WILLARD LN",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451559",
            "telephone_number": "978-423-4818",
            "fax_number": "781-631-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "AMY",
        "middle_name": "N",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle L Goldberg, LMFT
• Matthew Robert Goodnow, PSY.D, HSP
• Jill A. Grace Hersch, L.C.S.W.
• Stephanie Karahalis Green, M.D.
• Tracey G Green, LIC. AC.
• Group One Smiles PLLC
• Linda Guy
• Susan Mae Hamel, N.P.
• Amanda Tripp Hayes, PSY.D
• Leslie C Hazlett, LICSW

• All providers in Marblehead, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.