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General NPI Number Information
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NPI Number | 1417490145
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Entity Type | Organization
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Legal Business Name | GREENECARE COUNSELING LLC
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 401 S. LOCUST ST. , STE 102
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City | FLOYD
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State | VA
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Zip | 24091
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Country | US
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Telephone | 540-745-4700
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Fax | 540-745-4706
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Provider Business Mailing Address
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Address Line | PO BOX 975
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City | FLOYD
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State | VA
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Zip | 24091
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Country | US
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Telephone | 540-745-4700
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Fax | 540-745-4706
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELISE KAREN GREENE
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Credential | LCSW
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Telephone | 540-745-4700
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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 | 0904008170
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License Number State | VA
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