Kerry Lynn Green

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083504 Issued in NY

Practice address

400 SW 1St Ave Apt 906
Fort Lauderdale, FL 33301-3487

Phone

(908) 642-3644

NPI assigned

Jul 2, 2008

Last updated

May 3, 2023By 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 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1992968770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW 1ST AVE APT 2608",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013496",
            "telephone_number": "908-642-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW 1ST AVE APT 906",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013487",
            "telephone_number": "908-642-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 E 45th St",
            "address_2": "Room 224",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100173115",
            "country_code": "US",
            "telephone_number": "908-642-3644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 NW 167th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330564838",
            "country_code": "US",
            "telephone_number": "305-474-1753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KERRY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "13333",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13333",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085573",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Green
• Debra Lynn Green, ARNP
• Dory Green, DMD, FAGD
• Fiona Yvonne Green, LMT
• Jason Green, DO
• Railton Green, M.D.
• Shelley K Green, PH.D., LMFT
• Sherae Monique Green
• Wynette Benson Green, LMFT
• Rachel Lynn Greenberg

• Clinical Social Worker in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.