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NPI Code Detail

MEDICARE: MS. JULIETTE GREENBERG LCSW

MEDICARE: MS. JULIETTE GREENBERG LCSW
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
11041C0700XClinical Social Worker34007788AIN

General Provider Information

NPI Number : 1265965024
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIETTE GREENBERG LCSW
Provider Business Mailing Address
First Line : 7224 W 400 N
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-2903
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7224 W 400 N
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-2903
Country : US
Telephone Number : 219-879-4621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2017
Last Update Date : 04/09/2017

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