Individual ProviderMartha G GreenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1105 S College Rd, Ste A, Lafayette, LA 70503(337) 232-9113PECOS EnrollmentBased on the most recent information from CMS, provider Martha G Green does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1770528770Provider TypeIndividualFull NameGreen, Martha GTitleMrs.CredentialLCSWGenderFemaleEnumeration Date6/17/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1105 S College Rd, Ste A, Lafayette, LA 70503Phone(337) 232-9113Fax(337) 232-0022Mailing LocationMailing Address1105 S College Rd, Ste A, Lafayette, LA 70503Phone(337) 232-9113Fax(337) 232-0022Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense726LouisianaProvider IdentifiersIDDescriptionIssuerIDSCG20DescriptionOtherIssuerGROUP MEDICARE #Louisiana