Healthcare Provider Details

I. General information

NPI: 1609712850
Provider Name (Legal Business Name): STEVEN GREEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 MAYFIELD RD
CLEVELAND HEIGHTS OH
44118-1768
US

IV. Provider business mailing address

5174 AUSTEN LN
CLEVELAND OH
44143-2706
US

V. Phone/Fax

Practice location:
  • Phone: 216-269-0982
  • Fax:
Mailing address:
  • Phone: 216-269-0982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: