Individual provider Active NPI

Verlon Jean Green, LMSW

  • Clinical Social Worker
  • Indianola, MS
National Provider Identifier
1366902033
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C8144 Issued in MS
Practice address
627 Jefferson St
Indianola, MS 38751-3349
Phone
(662) 207-3557
NPI assigned
Mar 20, 2019
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C8144 MS Primary

Addresses

Primary practice location

627 Jefferson St
Indianola, MS 38751-3349

Mailing address

627 Jefferson St
Indianola, MS 38751-3349
Phone (662) 207-3557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20190524001330 MS Practitioner - Clinical Social Worker 4284977760 Reassigns benefits to 1 organization
Practice locations: Indianola, MS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7620 Clarington CV
Suite B
Southaven, MS 38671-5648
Phone (844) 215-0731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Therapy Group, LLC Clinical Current Accepting new patients
Pain Treatment Centers of America PLLC CurrentSince Apr 8, 2025 Accepting new patients
Pain Treatment Centers of America, PLLC CurrentSince Apr 8, 2025 Accepting new patients
Pain Treatment Centers of America PLLC Past Accepting new patients

Locations

1907 Lisa Drive Ext
Greenville, MS 38703
Phone (662) 334-2929

7620 Clarington Cv
#B
Southaven, MS 38671

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1366902033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 JEFFERSON ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387513349",
            "telephone_number": "662-207-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 JEFFERSON ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387513349",
            "telephone_number": "662-207-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "VERLON",
        "middle_name": "JEAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, MS

Sources for this page

Verify at the official NPI Registry.