MEDICARE: ALLAN GREENFIELD MS MSW PC

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

General Provider Information

NPI Number	:	1790839439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLAN GREENFIELD MS MSW PC

Provider Business Mailing Address
First Line	:	2301 E PIKES PEAK AVE
Second Line	:	# 203
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-8006
Country	:	US
Telephone Number	:	719-634-5800
Fax Number	:	719-578-5596

Provider Business Practice Location Address
First Line	:	2301 E PIKES PEAK AVE
Second Line	:	# 203
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-8006
Country	:	US
Telephone Number	:	719-634-5800
Fax Number	:	719-578-5596

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ALLAN RICHARD GREENFIELD
Credential	:	LCSW
Telephone Number	:	719-634-5800

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	10/09/2007

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