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General NPI Number Information
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NPI Number | 1154889657
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Entity Type | Individual
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Provider Name | ARIELLE GREENE MSW/LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 2502 N CLARK ST STE 217
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City | CHICAGO
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State | IL
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Zip | 60614-1850
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Country | US
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Telephone | 630-280-9627
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Fax |
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Provider Business Mailing Address
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Address Line | 3226 N SACRAMENTO AVE
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City | CHICAGO
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State | IL
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Zip | 60618-5860
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Country | US
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Telephone |
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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 | 149020703
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License Number State | IL
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