Active NPI
Mya Nicole Green, SOCIAL WORKER
- Social Worker
- Baton Rouge, LA
National Provider Identifier
1720961238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 19419
- Practice address
- 12628 Hooper Rd
Baton Rouge, LA 70818-3500 - Phone
- (225) 953-8170
- NPI assigned
- Jul 30, 2025
- Last updated
- Sep 23, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 19419 | LA | Primary |
Addresses
Primary practice location
12628 Hooper Rd
Baton Rouge, LA 70818-3500
Mailing address
38652 Red Bud LN
Denham Springs, LA 70706-0479
Phone (901) 277-7262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19419 | LA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758585600000",
"number": "1720961238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38652 RED BUD LN",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707060479",
"telephone_number": "901-277-7262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12628 HOOPER RD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708183500",
"telephone_number": "225-953-8170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MYA",
"middle_name": "NICOLE",
"credential": "SOCIAL WORKER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-30",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "19419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.