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

Jack Green, LICSW

Individual provider Clinical Social Worker · NPI 1700326907

Jack Green, LICSW is a Clinical Social Worker in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2017.

Licensed in
MA
In the registry since
2017
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

300 Longwood Ave
Boston, MA 02115-5724
Phone: (617) 355-6000
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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 125917 (MA)

Record details

NPI number1700326907
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedMarch 7, 2017
Last updated in NPPESNovember 13, 2025
Certification dateNovember 13, 2025

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