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General NPI Number Information
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NPI Number | 1922412873
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Entity Type | Organization
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Legal Business Name | DENISE GREENE PLLC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 119 S SHERRIN AVE STE 220
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City | LOUISVILLE
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State | KY
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Zip | 40207-3237
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Country | US
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Telephone | 502-836-3509
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Fax | 502-749-8933
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Provider Business Mailing Address
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Address Line | 9202 ARTIS WAY
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City | LOUISVILLE
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State | KY
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Zip | 40291-6718
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Country | US
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Telephone | 502-550-3486
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Fax | 502-231-0923
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DENISE ANN GREENE
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Credential | LCSW
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Telephone | 502-836-3509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1776
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License Number State | KY
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