Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chanel M Green

Individual provider Social Worker · NPI 1922776087

Chanel M Green is a Clinical Social Worker in Atlanta, Georgia. Qualified in 2016, 10 years ago. Practices with Lifesource of North Carolina, a 170-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
10
Licensed in
GA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

3117 Benninger Trce SW
Atlanta, GA 30331-6266
Phone: (678) 938-7590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CSW008390 (GA)
Social Worker Taxonomy 104100000X · Licence MSW007493 (GA)

Record details

NPI number1922776087
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 2, 2021
Last updated in NPPESFebruary 1, 2023
Certification dateFebruary 1, 2023
Mailing address3117 Benninger Trce Sw, Atlanta, GA 30331-6266

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Lifesource Of North Carolina — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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