Elizabeth Green

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58318 Issued in TX

Practice address

55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534

Phone

(800) 370-3651

Fax

(877) 515-7147

NPI assigned

Mar 15, 2017

Last updated

Mar 15, 2017By 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 TX

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

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1780125328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shragit Glazman, MD
• Jeffrey Stuart Goldblatt, M.D.
• Karl M Goldkamp, ND
• Mark Gombotz
• Jay Allan Graves, M.D.
• Ruth E Greenblatt, PT
• Joel Greenwood
• Mary Elizabeth Groth, A.P.R.N., P.M.H.S.
• Sharon Hallahan
• Kristin Hambidge, PSYD

• Clinical Social Worker in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.