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General NPI Number Information
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NPI Number | 1104278241
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Entity Type | Individual
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Provider Name | ELIZABETH CHRISTINE RANDOLPH-GREENE M.S., LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 4773 CAUGHLIN PKWY
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City | RENO
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State | NV
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Zip | 89519-1011
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Country | US
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Telephone | 775-221-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 1082 DAVOL ST
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City | FALL RIVER
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State | MA
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Zip | 02720-1124
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Country | US
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Telephone | 508-678-2833
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 01670-L
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP5880
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License Number State | NV
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