Tonia Talise Green, MSW, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2000165951 Issued in MO

Practice address

10043 Coburg Lands Dr
Saint Louis, MO 63137-1902

Phone

(314) 869-9314

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• It Takes a Village Enterprises

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1417181983
  NPD (past) Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336294271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10043 COBURG LANDS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631371902",
            "telephone_number": "314-869-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10043 COBURG LANDS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631371902",
            "telephone_number": "314-869-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TONIA",
        "middle_name": "TALISE",
        "name_prefix": "Ms.",
        "credential": "MSW, L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2000165951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495849507",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495849549",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495849531",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495849515",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salina Diane Green, M.D.
• Sherry L Green, NEMT
• Stephanie Green, LPC
• Sydney Green
• Sydney L Green, AA
• Faith Greenberg Waxman
• David D Greenberg, MD
• Jacob K Greenberg, MD
• Jason William Greenberg, MD
• Miggie L Greenberg, MD

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.