Provider Demographics
NPI:1083189690
Name:GREENWALD, CHRISTINE ORLOWSKI (LPCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ORLOWSKI
Last Name:GREENWALD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELIZABETH
Other - Last Name:ORLOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 FOUNTAIN PL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2205
Mailing Address - Country:US
Mailing Address - Phone:937-593-9600
Mailing Address - Fax:
Practice Address - Street 1:221 FOUNTAIN PL
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2205
Practice Address - Country:US
Practice Address - Phone:937-593-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003339A101YM0800X
OHE.1800892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health