Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jacqualyn F. Green, PHD

Individual provider Clinical Social Worker · NPI 1093861932

Dr. Jacqualyn F. Green, PHD is a Clinical Social Worker in Indianapolis, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2007
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

4755 Kingsway Dr Ste 308
Indianapolis, IN 46205-1571
Phone: (317) 257-6773
Fax: (317) 863-1414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 35000324A (IN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 34000712A (IN)

Record details

NPI number1093861932
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedJanuary 25, 2007
Last updated in NPPESSeptember 11, 2025

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