Joycelyn Green

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C8401 Issued in MS

Practice address

1100 Clay St
Vicksburg, MS 39183-2912

Phone

(601) 831-7325

Fax

(601) 501-7831

NPI assigned

Oct 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Kansas City Homeopathic Medical College, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• A Beautiful Mind Counseling Services

  • Mental Health Counselor
  • Vicksburg, MS
  • NPI 1386497162

  Mental Health, MS

  Medicare reassignment NPD Authorized official
• Positive Pathways, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vicksburg, MS
  • NPI 1801335492

  MS

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  LA, Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1649879461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NORTH DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391809304",
            "telephone_number": "601-831-7325",
            "fax_number": "601-501-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CLAY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832912",
            "telephone_number": "601-831-7325",
            "fax_number": "601-501-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOYCELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "19305",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8401",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Gray, PT
• Raymond Eugene Gray
• Amy Green, DPT
• Heather Ann Green, OTR/L
• Imani Janae Green
• Zandral Kewan Green
• Tawana Greene, RN, MSN, FNP-BC
• Greene'S Care, LLC
• Brent Wesley Greer, RPH
• Thulasi Ram Gudi, MD

• All providers in Vicksburg, MS
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.