Individual provider Active NPI

Beverly Ann Green, MSSW

  • Clinical Social Worker
  • Hudson, WI
National Provider Identifier
1932258969
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
813-123 Issued in WI
Practice address
131 Carmichael Rd Ste 206
Hudson, WI 54016-8271
Phone
(262) 789-1191
NPI assigned
Jan 9, 2007
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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 813-123 WI Primary

Addresses

Primary practice location

131 Carmichael Rd Ste 206
Hudson, WI 54016-8271

Mailing address

131 Carmichael Rd Ste 206
Hudson, WI 54016-8271
Phone (262) 789-1191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20070831000256 WI Practitioner - Clinical Social Worker 5395838676 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
River Valley Counseling, LLCGroup PAC ID 4981122736, 6 clinicians

Practice addresses (Care Compare)

131 Carmichael Rd
Suite 206
Hudson, WI 54016-8271
Phone (715) 690-2115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
813-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Croix County CurrentSince Dec 27, 2020 Accepting new patients
Cornerstone Counseling Services, Inc Mental Health CurrentSince Feb 26, 2024 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Jul 1, 2013 Accepting new patients
River Valley Counseling, LLC CurrentSince Apr 1, 2025 Accepting new patients
Baldwin Area Medical Center, Inc. Current Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Jul 1, 2013 Accepting new patients
St Croix County CurrentSince Dec 27, 2020 Accepting new patients

Locations

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

131 Carmichael Rd
Ste 206
Hudson, WI 54016
Phone (715) 690-2115

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

1445 N 4th St
New Richmond, WI 54017
Phone (715) 246-6991

1752 Dorset Ln
New Richmond, WI 54017
Phone (715) 246-6991

Interoperability endpoints

  • Direct secure messaging: beverly.green.1@32669.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1932258969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD STE 206",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168271",
            "telephone_number": "262-789-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD STE 206",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168271",
            "telephone_number": "262-789-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "credential": "MSSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "813-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.