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

Mrs. Theodora K Green, LSW, CADCRMA, DVA

Individual provider Clinical Social Worker · NPI 1255153391

Mrs. Theodora K Green, LSW, CADCRMA, DVA is a Clinical Social Worker in Evanston, Illinois. Qualified in 2023, 3 years ago. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2024
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

825 Chicago Ave Fl 2A
Evanston, IL 60202-2375
Phone: (312) 725-4088
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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 150.111842 (IL)

Record details

NPI number1255153391
Entity typeIndividual (Type 1)
GenderFemale
Credentials LSW , CADCRMA , DVA
Sole proprietorNo
NPI enumeratedOctober 29, 2024
Last updated in NPPESFebruary 19, 2026
Certification dateFebruary 19, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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