Christopher J Green, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18356 Issued in MN

Practice address

603 Bruce St
Crookston, MN 56716-2914

Phone

(218) 289-6081

Fax

(218) 281-6261

NPI assigned

Jun 25, 2009

Last updated

Jun 25, 2009By the provider in NPPES

Sex

Male

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 MN

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

Specialty

Clinical Social Worker

Education

University of North Dakota School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alluma IncGroup PAC ID 6709787609, 23 clinicians

Practice addresses (Care Compare)

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.

• Alluma, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Crookston, MN
  • NPI 1508835133
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1942438239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-289-6081",
            "fax_number": "218-281-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-289-6081",
            "fax_number": "218-281-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Glass, LADC
• Ian Glidden, MD
• Braydon Gourneau
• Michael A Graner, LADC
• Great Plains EMS, Inc.
• Amanda Grzadzielewski
• Denise Rose Gudvangen, LP
• Wayne Scott Halvorson
• Denise Elaine Hammer, LICSW
• Curtis Lee Hamre, LADC

• Clinical Social Worker in Crookston, MN
• Providers in Crookston, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.