Jon Adam Green, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P022175 Issued in NC

Practice address

7850 Brier Creek Pkwy Ste 102
Raleigh, NC 27617-8900

Phone

(984) 263-0846

NPI assigned

Jun 19, 2025

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  NPD

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1275420614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WESTVIEW DR",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101501",
            "telephone_number": "678-467-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 BRIER CREEK PKWY STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178900",
            "telephone_number": "984-263-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JON",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P022175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Ann Green
• Corinne Green, PH.D.
• Emily Marie Green, RN, IBCLC
• Heidi Louise Green, M.D.
• Iyana Sarah - Antwanette Green
• Jonathan S Green, MD
• Latonia Green
• Lavita Crutcher Green, MSSW, LCSW
• Mitzi Green, COTA/L
• Stella Louise Green, LCAS

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

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