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 33 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