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NPI Code Detail

MEDICARE: GREENTREE COUNSELING CENTER

MEDICARE: GREENTREE COUNSELING CENTER
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043741465
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREENTREE COUNSELING CENTER
Provider Business Mailing Address
First Line : 430 FRANKLIN ST SE
Second Line :
City : WARREN
State : OH
Zip : 44483-5715
Country : US
Telephone Number : 330-372-2200
Fax Number :
Provider Business Practice Location Address
First Line : 430 FRANKLIN ST SE
Second Line :
City : WARREN
State : OH
Zip : 44483-5715
Country : US
Telephone Number : 330-372-2200
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MELISSA MONTGOMERY
Credential : LPCC
Telephone Number : 330-372-2200
Provider Enumeration Date : 03/27/2017
Last Update Date : 03/27/2017

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