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General NPI Number Information
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NPI Number | 1760191563
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Entity Type | Individual
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Provider Name | MRS. KAI SIEDAH GREENE
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Gender | Female
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 2857 LINDEN BLVD
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City | BROOKLYN
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State | NY
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Zip | 11208-5126
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Country | US
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Telephone | 718-235-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 NEW YORK AVE APT 5D
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City | BROOKLYN
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State | NY
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Zip | 11210-1632
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Country | US
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Telephone | 917-704-5984
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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