MEDICARE: VALERIE GREENE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904010846	VA

General Provider Information

NPI Number	:	1144889270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE GREENE

Provider Business Mailing Address
First Line	:	1000 JEFFERSON ST STE 2C
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24504-1724
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3804 POPLAR HILL RD UNIT D
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5532
Country	:	US
Telephone Number	:	757-414-6427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2019
Last Update Date	:	06/12/2019

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Directions to “ VALERIE GREENE ” Practice Location

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