MEDICARE: RACHEL N GREENE MSW, LCSW

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	101YM0800X	Mental Health Counselor	217761	MA
2	1041C0700X	Clinical Social Worker	SW12182	FL

General Provider Information

NPI Number	:	1285986935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL N GREENE MSW, LCSW

Provider Business Mailing Address
First Line	:	1210 E PARK AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-2653
Country	:	US
Telephone Number	:	850-739-2448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 E PARK AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-2653
Country	:	US
Telephone Number	:	850-739-2448
Fax Number	:

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

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	11/03/2022

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