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NPI Code Detail

MEDICARE: ANNA GRACE GREEN

MEDICARE: ANNA GRACE GREEN
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
1101YP2500XProfessional Counselor
2101Y00000XCounselor

General Provider Information

NPI Number : 1124618475
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA GRACE GREEN
Provider Business Mailing Address
First Line : G3169 BEECHER RD
Second Line :
City : FLINT
State : MI
Zip : 48532-3611
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : G3169 BEECHER RD
Second Line :
City : FLINT
State : MI
Zip : 48532-3611
Country : US
Telephone Number : 810-232-2766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2021
Last Update Date : 04/21/2026

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1316972581 — DR. JOHN R SOCEY D.O.
Practice Location Address:
G3169 BEECHER RD , SUITE 102
FLINT, MI
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Directions to “ ANNA GRACE GREEN ” Practice Location

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