Active NPI
Portia Green
- Clinical Social Worker
- Meriden, CT
National Provider Identifier
1801444500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12540
- Practice address
- 130 Research Pkwy
Meriden, CT 06450-7152 - Phone
- (203) 235-1654
- NPI assigned
- Aug 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4746 | CT | |
| Clinical Social Worker | 1041C0700X | 12540 | CT | Primary |
Addresses
Primary practice location
130 Research Pkwy
Meriden, CT 06450-7152
Mailing address
80 Webster St
New Haven, CT 06511-3648
Phone (203) 645-1036
Other practice location 1
883 Paddock Ave
Meriden, CT 06450-7044
Phone (203) 634-7020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4746 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rushford Center, Inc. | Clinical | Current | Accepting new patients |
Locations
883 Paddock Ave
Meriden, CT 06450
Phone (203) 630-5220
Interoperability endpoints
- portia.green.p1@direct.wheelerclinic.nextgenshare.com
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Plainville, CT
- NPI 1396750840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1801444500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 WEBSTER ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065113648",
"telephone_number": "203-645-1036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 RESEARCH PKWY",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064507152",
"telephone_number": "203-235-1654"
}
],
"practiceLocations": [
{
"address_1": "883 Paddock Ave",
"address_purpose": "LOCATION",
"city": "Meriden",
"state": "CT",
"postal_code": "064507044",
"country_code": "US",
"telephone_number": "203-634-7020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "PORTIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "4746",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "12540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.