Jason Owen Greenly, BA, MHP

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

70 E Washington St
Champaign, IL 61820-3652

Phone

(217) 398-7785

Fax

(217) 398-7787

NPI assigned

Sep 4, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1710171699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 W WHITE ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213114",
            "telephone_number": "217-355-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 E WASHINGTON ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203652",
            "telephone_number": "217-398-7785",
            "fax_number": "217-398-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLY",
        "first_name": "JASON",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "BA, MHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.