Clark William Green

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

Anchorage Community Mental Health 4020 Folker Street
Anchorage, AK 99508

Phone

(907) 762-8606

NPI assigned

Apr 13, 2009

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1205079845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11860 PORTAGE CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153100",
            "telephone_number": "907-444-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ANCHORAGE COMMUNITY MENTAL HEALTH 4020 FOLKER STREET",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-762-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CLARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes Green
• Amanda Renee Green, PHARM.D.
• Bailey Philadelphia Green, PA-C
• Bobbi D Green
• Brian D. Green, LPC
• Deborah Green, RN
• Eve Elaine Green, LMT
• Je'Dette Angelique Green, ANP-C
• Jyll K Green, ANP
• Kameisa J Green

• Clinical Social Worker in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.