MEDICARE: MS. CLAIRE GREENE 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	1041C0700X	Clinical Social Worker	LCS15513	CA

General Provider Information

NPI Number	:	1851566152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLAIRE GREENE LCSW

Provider Business Mailing Address
First Line	:	22704 VENTURA BLVD # 295
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-1333
Country	:	US
Telephone Number	:	818-227-9444
Fax Number	:	818-227-9799

Provider Business Practice Location Address
First Line	:	22704 VENTURA BLVD
Second Line	:	#295
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-1333
Country	:	US
Telephone Number	:	818-227-9444
Fax Number	:	818-227-9799

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

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	04/28/2008

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