Theodora K Green, LSW, CADC RMA, DVA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

150.111842 Issued in IL

Practice address

825 Chicago Ave FL 2a
Evanston, IL 60202-2375

Phone

(312) 725-4088

NPI assigned

Oct 29, 2024

Sex

Female

Sole proprietor

No

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 IL

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, 2023

Medicare assignment

May accept Medicare assignment

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.

• Psychiatry of Texas PLLC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1013476027

  IL, Mental Health

  Medicare reassignment NPD
• Psychplus Medical Associates, PLLC

  • Family Medicine Physician
  • Houston, TX
  • NPI 1558118026

  IL

  Medicare reassignment NPD
• Orange Tree Counseling and Consulting, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1508452434

  Mental Health

  NPD

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1255153391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SIMPSON ST # 1A",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342459",
            "telephone_number": "312-725-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHICAGO AVE FL 2A",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022375",
            "telephone_number": "312-725-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "THEODORA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LSW, CADC RMA, DVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150.111842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Chicago Urology
• Green Bay Trail Dentistry
• Alysia L Green, MD
• Ian F Green, MD, MPH
• Terrence Green Sr.
• Shelly Greenawalt, COTA/L
• Karen Beth Greenberg, LCSW
• Steven Brett Greenberg, MD
• Kathy S. Greenberger, PSY.D.
• Constance Greene, LSW

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.