Provider Demographics
NPI:1083035349
Name:GREENE, DOROTHY SAXON (LCSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:SAXON
Last Name:GREENE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:LOUISE
Other - Last Name:SAXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LCAS
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684-0699
Mailing Address - Country:US
Mailing Address - Phone:423-439-8000
Mailing Address - Fax:423-439-2200
Practice Address - Street 1:BLDG. 52 LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684-0699
Practice Address - Country:US
Practice Address - Phone:423-439-8000
Practice Address - Fax:423-439-2200
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC966101YA0400X
NCC0054331041C0700X
TN59361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)