MEDICARE: AMBER N GREEN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34008539A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518333236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER N GREEN MSW

Provider Business Mailing Address
First Line	:	101 N PLAZA EAST BLVD STE 106
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2804
Country	:	US
Telephone Number	:	812-508-8418
Fax Number	:	812-508-8478

Provider Business Practice Location Address
First Line	:	101 N PLAZA EAST BLVD STE 106
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2804
Country	:	US
Telephone Number	:	812-508-8418
Fax Number	:	812-508-8478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	02/03/2026

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Directions to “ AMBER N GREEN MSW” Practice Location

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