Healthcare Provider Details

I. General information

NPI: 1861959116
Provider Name (Legal Business Name): KATE GREENEN LMFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 PUTNEY RD # 301
BRATTLEBORO VT
05301-9000
US

IV. Provider business mailing address

262 WESTERN AVE RM 2
BRATTLEBORO VT
05301-6246
US

V. Phone/Fax

Practice location:
  • Phone: 802-451-6055
  • Fax:
Mailing address:
  • Phone: 802-451-6055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN M GREENEN
Title or Position: OWNER
Credential: LMFT
Phone: 802-451-6055