MEDICARE: CIERAH GREENE LPC

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	37PC01105500	NJ

General Provider Information

NPI Number	:	1396490975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIERAH GREENE LPC

Provider Business Mailing Address
First Line	:	1300 S COLUMBUS BLVD
Second Line	:	SITE 1, BOX #1022
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-5529
Country	:	US
Telephone Number	:	856-213-2553
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 S COLUMBUS BLVD
Second Line	:	SITE 1, BOX # 1022
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147
Country	:	US
Telephone Number	:	856-213-2553
Fax Number	:

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

Provider Enumeration Date	:	02/13/2022
Last Update Date	:	05/27/2026

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Directions to “ CIERAH GREENE LPC” Practice Location

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