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JESSICA GREEN LPC
NPI 1104221811
Counselor - Mental Health in Hartsville, SC

Active since October 24, 2014PECOS EnrolledAccepts Medicare Assignment
1268 S 4TH ST, HARTSVILLE, SC 29550(843) 332-3422(843) 332-3985 Get Directions Write a Review

NPPES record last updated: May 9, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 9, 2024, Jun 25, 2020, Jan 22, 2016 (3 updates tracked since 2016).

About Jessica Green Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA GREEN LPC (NPI 1104221811) is an individual mental health provider in Hartsville, South Carolina, licensed in South Carolina (6910) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1104221811
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJESSICA GREENCredential: LPC
Location Address1268 S 4TH STHartsville, SC 29550-0703
Mailing AddressPo Box 1090Hartsville, SC 29551-1090 · (843) 857-0111 · Fax (843) 857-0206
Phone(843) 332-3422
Fax(843) 332-3985
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateOctober 24, 2014
Last NPPES UpdateMay 9, 20243 updates tracked since enumeration
NPPES CertifiedMay 9, 2024
✔ NPI 1104221811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in SC · 6910
1268 S 4TH ST, Hartsville, SC 29550
Open in Google Maps ↗

Other Identifiers 2

MedicaidPC1862SC
OtherSCS668SC · Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next, InStil Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessica Green Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325488968
PECOS Enrollment IDI20240430003515
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jessica Green reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Caresouth Carolina, Inc.
Same address
Federally Qualified Health Center (FQHC)
1268 S 4TH ST
Hartsville, SC 29550
  • Reassigned Medicare billing, South Carolina enrollment
  • 95 clinicians in this Medicare group
NPI 1720082571 (843) 332-3422

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ZITA ACUNA ANDRESKI APRN FNP-C
Nurse Practitioner (Family)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-3422
KATELON MARIE SMITH FNP-C
Nurse Practitioner (Family)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-3422
STACI LEIGH CASSIDY NP
Nurse Practitioner (Family)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-3422
JOCELYN BOYER DEEDEE
Social Worker (Clinical)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-3422
AMY LAW PHARMD
Pharmacist
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 339-5530
AQUILLA BEC
Nurse Practitioner (Pediatrics)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-0118
MS. ALMEDA MYERS GRAHAM
Nurse Practitioner (Family)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-3422
MS. ELIZABETH ANNE SORG
Nurse Practitioner (Family)
1268 S 4TH ST
HARTSVILLE, SC 29550
Darlington County (843) 332-3422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Green's NPI number?

The NPI number for Jessica Green is 1104221811. It was assigned to this individual provider in the NPPES registry on October 24, 2014.

Where is Jessica Green located?

Jessica Green practices at 1268 S 4th St, Hartsville, SC 29550. The listed phone number is (843) 332-3422.

What is Jessica Green's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jessica Green enrolled in Medicare?

Yes. Jessica Green is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jessica Green's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Green reassigns Medicare benefits to Caresouth Carolina, Inc. (Hartsville, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jessica Green's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Green accept?

Health plans from BlueCross BlueShield of South Carolina, First Choice Next and InStil Health list Jessica Green as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jessica Green was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.