Provider Demographics
NPI:1043794910
Name:GREENE, KRISTEN SCARLETT (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:SCARLETT
Last Name:GREENE
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 DELTA LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-2838
Mailing Address - Country:US
Mailing Address - Phone:828-748-6366
Mailing Address - Fax:
Practice Address - Street 1:16600 BIRKDALE COMMONS PKWY STE D
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6181
Practice Address - Country:US
Practice Address - Phone:704-564-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical