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General NPI Number Information
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NPI Number | 1073449211
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Entity Type | Organization
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Legal Business Name | GREENLIFE THERAPY PLLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 1002 VANDORA SPRINGS RD UNIT 115
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City | GARNER
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State | NC
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Zip | 27529-3546
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Country | US
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Telephone | 984-584-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 VANDORA SPRINGS RD UNIT 115
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City | GARNER
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State | NC
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Zip | 27529-3546
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Country | US
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Telephone | 984-584-8833
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | JENNIFER DAWN SMITH
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Credential | LCSW
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Telephone | 984-584-8833
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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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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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