Jacquelyn Greene

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18424 Issued in MD

Practice address

544 Greenblades CT
Arnold, MD 21012-1966

Phone

(443) 994-1633

NPI assigned

Aug 29, 2022

Last updated

Aug 29, 2022By the provider in NPPES

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

Enrolled in MD

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aspen Day Treatment LLCGroup PAC ID 8729160635, 6 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspen Day Treatment, LLC

  dba Aspen Day Treatment

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1023366796
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1700506029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 GREENBLADES CT",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121966",
            "telephone_number": "443-994-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 GREENBLADES CT",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121966",
            "telephone_number": "443-994-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan B R Gibbons, PHD, LCSW-C
• Kimberly Gillette
• Glen Burnie Physical Therapy & Sportscare, LLC (Pivot Physical Therapy of Greater Baltimore)
• Stacie Gold, LCSW-C
• Kaitlyn Marie Govatos, PA-C
• Donna Greenfield, FNP,CNM
• Billy Louis Greer
• Rhiannon Gruppuso, LCSWC
• Catherine Gvozden, CRNP
• Kathleen Haefner

• Clinical Social Worker in Arnold, MD
• Providers in Arnold, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.