Individual provider Active NPI

Elizabeth D. Green, LCSW

  • Clinical Social Worker
  • Canton, GA
National Provider Identifier
1720471303
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006061 Issued in GA
Practice address
2205 Riverstone Blvd Ste 254
Canton, GA 30114-5254
Phone
(770) 778-6997
Fax
(833) 633-4467
NPI assigned
Mar 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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 CSW006061 GA Primary

Addresses

Primary practice location

2205 Riverstone Blvd Ste 254
Canton, GA 30114-5254

Mailing address

2205 Riverstone Blvd Ste 254
Canton, GA 30114-5254
Phone (770) 778-6997

Other practice location 1

3100 Interstate North Cir SE
Atlanta, GA 30339-2227
Phone (770) 778-6997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20181025000513 GA Practitioner - Clinical Social Worker 1153695986 Reassigns benefits to 1 organization
Practice locations: Canton, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2205 Riverstone Blvd
Suite 254
Canton, GA 30114-5254
Phone (770) 778-6997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Behavioral and Mental Health Counseling Clinical CurrentSince Mar 11, 2026 Accepting new patients

Locations

3100 Interstate North Cir SE
Atlanta, GA 30339
Phone (770) 778-6997

2205 Riverstone Blvd
Ste 254
Canton, GA 30114
Phone (770) 778-6997

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": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1720471303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 RIVERSTONE BLVD STE 254",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145254",
            "telephone_number": "770-778-6997",
            "fax_number": "833-633-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 RIVERSTONE BLVD STE 254",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145254",
            "telephone_number": "770-778-6997",
            "fax_number": "833-633-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Interstate North Cir SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303392227",
            "country_code": "US",
            "telephone_number": "770-778-6997",
            "fax_number": "833-633-4467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ELIZABETH",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-06",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.