MEDICARE: MS. MARILYN GREENE L.M.H.C.

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	101Y00000X	Counselor	002030-1	NY

General Provider Information

NPI Number	:	1053637645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN GREENE L.M.H.C.

Provider Business Mailing Address
First Line	:	P.O. BOX 722
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456
Country	:	US
Telephone Number	:	315-719-9002
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 SENECA STREET
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456
Country	:	US
Telephone Number	:	315-719-9002
Fax Number	:

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

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	02/08/2026

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