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General NPI Number Information
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NPI Number | 1073433876
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Entity Type | Individual
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Provider Name | MICHAEL M. GREENWOOD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 304 N JUNCTION ST
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City | GRANGEVILLE
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State | ID
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Zip | 83530-1724
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Country | US
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Telephone | 509-220-7960
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Fax |
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Provider Business Mailing Address
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Address Line | 304 N JUNCTION ST
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City | GRANGEVILLE
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State | ID
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Zip | 83530-1724
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Country | US
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Telephone | 509-220-7960
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-7576
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License Number State | ID
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