The Green Fern, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE GREEN FERN, LLC

Practice address

900 S Shackleford Rd
Little Rock, AR 72211-3817

Phone

(501) 794-9496

NPI assigned

Sep 2, 2025

Organization subpart

No

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

Authorized official

Name

Kellie Fugere, LCSW 7926-CNPI 1205285566

Title

Organizer/Manager/Officer

Phone

(501) 794-9496

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellie Fugere

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1205285566

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1336029313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1853",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720181853",
            "telephone_number": "501-794-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113817",
            "telephone_number": "501-794-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GREEN FERN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "FUGERE",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "ORGANIZER/MANAGER/OFFICER",
        "authorized_official_telephone_number": "501-794-9496",
        "authorized_official_credential": "LCSW 7926-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.