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General NPI Number Information
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NPI Number | 1053884676
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Entity Type | Individual
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Provider Name | MONTREECE NICOLE GREEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 558 COUNTY ROAD 356
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City | ADKINS
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State | TX
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Zip | 78101-2407
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Country | US
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Telephone | 210-860-0637
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 200764
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City | SAN ANTONIO
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State | TX
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Zip | 78220-0764
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Country | US
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Telephone | 210-860-0637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 57821
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License Number State | TX
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