Active NPI
Clifford Childs Green, PSYD, LCSW
- Clinical Social Worker
- Honolulu, HI
National Provider Identifier
1285058610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-4581
- Practice address
- 2211 Ala Wai Blvd Apt 2101
Honolulu, HI 96815-2405 - Phone
- (808) 256-6119
- NPI assigned
- Feb 5, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-4581 | HI | Primary |
| Social Worker | 104100000X | LSW-2093 | HI |
Addresses
Primary practice location
2211 Ala Wai Blvd Apt 2101
Honolulu, HI 96815-2405
Mailing address
2211 Ala Wai Blvd Apt 2101
Honolulu, HI 96815-2405
Phone (808) 256-6119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW-2093 | HI | MD | Social Worker |
| LCSW-4581 | HI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599177600000",
"number": "1285058610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2211 ALA WAI BLVD APT 2101",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968152405",
"telephone_number": "808-256-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 ALA WAI BLVD APT 2101",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968152405",
"telephone_number": "808-256-6119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "CLIFFORD",
"middle_name": "CHILDS",
"credential": "PSYD, LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-05",
"last_updated": "2020-09-04",
"certification_date": "2020-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "HI",
"license": "LCSW-4581",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "HI",
"license": "LSW-2093",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.