MR. JACQUES DEWAYNE GREEN (LMSW) – Clinical Social Worker, NPI 1841482791

MR. JACQUES DEWAYNE GREEN (LMSW) is a healthcare provider. based in Rockford, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801089203 (MI). The NPI Number for MR. JACQUES DEWAYNE GREEN (LMSW) is 1841482791

Main info

Male
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACQUES DEWAYNE GREEN (LMSW)
NPI
1841482791
Phone
Not provided
Address
129 DOGWOOD DR NE
Enumeration Date
15 August 2007
Last Update Date
3 May 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6168053660
Graduation Year
2007 (19 years ago)
PAC ID
1850616020
Group Practice PAC ID
9234469255
Professional Enrollment ID
I20150210001341
Address ID
MI493411287RO65XXXSTXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:18State licenses:2Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

Provider Addresses for MR. JACQUES DEWAYNE GREEN (LMSW)

  • 129, Dogwood Drive Northeast, Rockford, Kent County, Michigan, 49341, United States

    ROCKFORD, MI 493417396

    Phone:

    Type: Mailing

  • 359 DIVISION AVE S

    GRAND RAPIDS, MI 495034537

    Phone: (616) 685-3800

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-02-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150210001341IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49341)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234469255View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Mental Health CounselorMI
-MI
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical PsychologistMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Where can patients find MR. JACQUES DEWAYNE GREEN (LMSW)'s NPI?
You can confirm MR. JACQUES DEWAYNE GREEN (LMSW) with NPI 1841482791; it appears in the national provider directory.
Is MR. JACQUES DEWAYNE GREEN (LMSW) active in the national directory?
MR. JACQUES DEWAYNE GREEN (LMSW)'s public NPI profile is in an active state.
What does MR. JACQUES DEWAYNE GREEN (LMSW) treat or focus on?
Patients typically see MR. JACQUES DEWAYNE GREEN (LMSW) under the specialty Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is MR. JACQUES DEWAYNE GREEN (LMSW)'s primary listing?
We display Rockford, Michigan because that is what the record indicates for MR. JACQUES DEWAYNE GREEN (LMSW).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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