Kelley Lorraine Green, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60619498 Issued in WA

Practice address

19116 33Rd Ave W
Lynnwood, WA 98036-4706

Phone

(425) 712-7900

NPI assigned

Jul 16, 2021

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 WA

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

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment Care Compare group NPD
• Virginia Mason Medical Center

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1730237942
  NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1962074088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981017026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19116 33RD AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364706",
            "telephone_number": "425-712-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KELLEY",
        "middle_name": "LORRAINE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60619498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick A Gray, MED, LMHC
• Lindsey Greeling, PT, DPT
• Green Day Clinic
• Aleksey Brooke Green
• Christopher Isaiah Green, L.M.P.
• Marissa Rose Green, ARNP
• Noralee Green, MCD, CCC
• Valerie Green, LMT
• Stephanie Anne Marie Greenall, DC
• Kathryn Greene, OTR/L

• Clinical Social Worker in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.