Pamela Green

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-14074 Issued in AZ

Practice address

15439 W Lea LN
Surprise, AZ 85374-4806

Phone

(623) 556-3805

NPI assigned

Feb 25, 2014

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

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shoreline Counseling LLCGroup PAC ID 4587985049, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Shoreline Counseling LLC

  • Clinical Social Worker
  • Astoria, OR
  • NPI 1437548807
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1477978641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15439 W LEA LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744806",
            "telephone_number": "623-556-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15439 W LEA LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744806",
            "telephone_number": "623-556-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "PAMELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-14074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adara Greathouse
• Donovan Greathouse
• Charise Green, RB
• Chelsea Green
• Lauryn Cate Green
• Shawna A. Green, LAMFT
• Tiffany M Green, LPC
• Daniel Michael Greenblatt, AU.D.
• Greenway Dentistry, LLC
• Greenway303 Chiropractic P.C.

• Clinical Social Worker in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.