Provider Demographics
NPI:1013387257
Name:GREENHOUSE, KEVIN MCKAY (MHP)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MCKAY
Last Name:GREENHOUSE
Suffix:
Gender:M
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6506
Mailing Address - Country:US
Mailing Address - Phone:225-926-9706
Mailing Address - Fax:225-926-9708
Practice Address - Street 1:8706 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2233
Practice Address - Country:US
Practice Address - Phone:225-926-9706
Practice Address - Fax:225-926-9708
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator