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General NPI Number Information
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NPI Number | 1699171199
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Entity Type | Individual
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Provider Name | JENNIFER A GREENE LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 1133 STATE ROUTE 55
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5051
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Country | US
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Telephone | 845-654-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 5 ROLLING GREEN LN
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-6436
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Country | US
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Telephone | 845-654-3443
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 093635
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 090230
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License Number State | NY
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