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General NPI Number Information
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NPI Number | 1205394236
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Entity Type | Individual
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Provider Name | TARA LEE GREENE LMHC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 2180 N PARK AVE STE 328
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City | WINTER PARK
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State | FL
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Zip | 32789-2358
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Country | US
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Telephone | 407-719-2758
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Fax | 407-629-6447
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Provider Business Mailing Address
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Address Line | 2180 N PARK AVE STE 328
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City | WINTER PARK
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State | FL
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Zip | 32789-2358
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Country | US
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Telephone | 407-719-2758
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Fax | 407-629-6447
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2610
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License Number State | FL
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