Individual provider Active NPI

Anna C Green, LICSW

  • Clinical Social Worker
  • Madison, AL
National Provider Identifier
1699306308
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4012C Issued in AL
Practice address
600 Sun Temple Dr
Madison, AL 35758-8643
Phone
(256) 288-3333
Fax
(256) 288-3334
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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 4012C AL Primary

Addresses

Primary practice location

600 Sun Temple Dr
Madison, AL 35758-8643

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN, MS3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200415002745 AL Practitioner - Clinical Social Worker 2163852112 Reassigns benefits to 1 organization
I20241212001057 TN Practitioner - Clinical Social Worker 2163852112 Reassigns benefits to 1 organization
I20250121001915 MS Practitioner - Clinical Social Worker 2163852112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

101 Ivy LN
Pulaski, TN 38478-4549
Phone (256) 288-3333

2740 Pass Rd
Biloxi, MS 39531-2626
Phone (256) 288-3333

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9483TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health, Inc. Clinical CurrentSince Apr 1, 2020 Accepting new patients

Locations

350 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

2740 Pass Rd
Biloxi, MS 39531
Phone (228) 276-1860

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

469 Weakley Creek Rd
Lawrenceburg, TN 38464
Phone (931) 766-0660

101 Ivy Ln
Pulaski, TN 38478
Phone (931) 363-3633

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1699306308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333",
            "fax_number": "256-288-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333",
            "fax_number": "256-288-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ANNA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4012C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.