Individual
JONATHAN EDWARD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
535 W 77TH STREET NORTH DR, INDIANAPOLIS, IN 46260-3502
(773) 203-8651
Mailing address
535 W 77TH STREET NORTH DR, INDIANAPOLIS, IN 46260-3502
(773) 203-8651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34012888A
IN
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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