MEDICARE: HELENE D GREENWALD PHD LLC

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	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1962113738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELENE D GREENWALD PHD LLC

Provider Business Mailing Address
First Line	:	10484 NADINE AVE
Second Line	:
City	:	HUNTINGTON WOODS
State	:	MI
Zip	:	48070-1518
Country	:	US
Telephone Number	:	248-752-7946
Fax Number	:

Provider Business Practice Location Address
First Line	:	10484 NADINE AVE
Second Line	:
City	:	HUNTINGTON WOODS
State	:	MI
Zip	:	48070-1518
Country	:	US
Telephone Number	:	248-752-7946
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. HELENE GREENWALD
Credential	:	PH.D.
Telephone Number	:	248-752-7946

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	12/04/2023

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