Healthcare Provider Details
I. General information
NPI: 1720999006
Provider Name (Legal Business Name): GREENTOWER COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US
IV. Provider business mailing address
82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US
V. Phone/Fax
- Phone: 904-755-4425
- Fax:
- Phone: 904-755-4425
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RYAN
JAMES
WARNER
Title or Position: CLINICAL DIRECTOR/OWNER
Credential: LMHC
Phone: 904-755-4425