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General NPI Number Information
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NPI Number | 1033809454
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Entity Type | Organization
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Legal Business Name | THE GREENE PROJECT COUNSELING
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 27010 JOY RD
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City | REDFORD
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State | MI
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Zip | 48239-1949
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Country | US
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Telephone | 734-682-2259
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Fax | 248-482-7455
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Provider Business Mailing Address
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Address Line | 27010 JOY RD
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City | REDFORD
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State | MI
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Zip | 48239-1949
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Country | US
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Telephone | 734-682-2259
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JERUSHA FAYE NELSON-BRENT
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Credential | LPC
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Telephone | 313-525-7131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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