Individual provider · Type 1 NPI

Tanya Laurette Green, MSW

Clinical Social Worker · Fort Wayne, IN

NPI number 1689632804 Active

Practice location

310 E Dupont Rd
Fort Wayne, IN 46825-2048

Call (260) 490-8110 Map

Fax (260) 490-7707

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X34005094A (IN)
Clinical Social Worker 1041C0700X1531 (OK)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1689632804

Tanya Laurette Green, MSW's National Provider Identifier is 1689632804, issued on May 4, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 13, 2026.