MEDICARE: MS. CONSTANCE MATTHEWS GRECO L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	359	AK

General Provider Information

NPI Number	:	1013259936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CONSTANCE MATTHEWS GRECO L.C.S.W.

Provider Business Mailing Address
First Line	:	10250 JAMESTOWN DR APT 15
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-5337
Country	:	US
Telephone Number	:	907-522-8170
Fax Number	:

Provider Business Practice Location Address
First Line	:	10250 JAMESTOWN DR APT 15
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-5337
Country	:	US
Telephone Number	:	907-522-8170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	03/18/2013

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