Myranda Su Green, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

385 Leonard St NE
Grand Rapids, MI 49503-1129

Phone

(616) 591-4891

NPI assigned

May 21, 2019

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1497312904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031129",
            "telephone_number": "616-591-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031129",
            "telephone_number": "616-591-4891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "799 Hombach St",
            "address_purpose": "LOCATION",
            "city": "Saint Ignace",
            "state": "MI",
            "postal_code": "497811735",
            "country_code": "US",
            "telephone_number": "616-591-4891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Manley St",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494242110",
            "country_code": "US",
            "telephone_number": "616-591-4891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MYRANDA",
        "middle_name": "SU",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie M Green, MSW
• Kelly Alaine Green, LMSW
• Kendall Leigh Green, LLMSW
• Kristen Green
• Micah Green
• Rae Green, LPC
• Randall William Green, MD
• Rebekah Marie Green, MA CCC-SLP
• Regina Green
• Shaetiaunna Green

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.