Healthcare Provider Details

I. General information

NPI: 1437127438
Provider Name (Legal Business Name): GREENTREE COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 FRANKLIN ST
WARREN OH
44483
US

IV. Provider business mailing address

430 FRANKLIN STREET SE
WARREN OH
44483
US

V. Phone/Fax

Practice location:
  • Phone: 330-372-2200
  • Fax: 330-372-2600
Mailing address:
  • Phone: 330-372-2200
  • Fax: 330-372-2600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. MELISSA MARIE MONTGOMERY
Title or Position: PRESIDENT
Credential: LPCC
Phone: 330-372-2200