Provider Demographics
NPI:1063658599
Name:GREENFIELD, RICHARD M
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WHITEFORD CT STE A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7828
Mailing Address - Country:US
Mailing Address - Phone:803-808-1800
Mailing Address - Fax:803-356-8580
Practice Address - Street 1:130 WHITEFORD CT STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7828
Practice Address - Country:US
Practice Address - Phone:803-808-1800
Practice Address - Fax:803-356-8580
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC4631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health