Lacy Dawn Green
Individual provider Active NPI Clinical Social Worker · Gainesville, MO
NPI 1689554347 · NPPES record last updated Sep 4, 2025
Key facts
- NPI
- 1689554347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2025037160 (MO)
- Practice address
- 87 Elm St
Gainesville, MO 65655-7131 - Phone
- (417) 679-2775
- NPI assigned
- Sep 4, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025037160 | MO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2025037160 | MO | Yes |
Addresses
Primary practice location
87 Elm St
Gainesville, MO 65655-7131
Mailing address
PO Box 1359
Ava, MO 65608-1359
Phone (417) 683-1111
Other providers in Gainesville, MO
- Firstcall Family Healthcare
- Gainesville Pharmacy LLC
- Gainesville R-V School District
- Chris V Geroff
- Rebecca Marie Gosdin
- Healing Intentionally, LLC
- Edward Henegar
- Mina K Higgins
- Devin Hillman
- Heather Rose Hoffman
All providers in Gainesville, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.