Provider Demographics
NPI:1073276705
Name:GREEN ZONE COUNSELING
Entity Type:Organization
Organization Name:GREEN ZONE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:207-592-6911
Mailing Address - Street 1:6 BALDWIN ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7102
Mailing Address - Country:US
Mailing Address - Phone:207-592-6911
Mailing Address - Fax:
Practice Address - Street 1:6 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7102
Practice Address - Country:US
Practice Address - Phone:207-592-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)