Provider Demographics
NPI:1083222632
Name:GREEN, ALLISON (MSW, LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:GREEN
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 1:121 ROLLING HILL RD STE 225
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8861
Mailing Address - Country:US
Mailing Address - Phone:704-534-5997
Mailing Address - Fax:704-230-1397
Practice Address - Street 1:121 ROLLING HILL RD STE 225
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8861
Practice Address - Country:US
Practice Address - Phone:704-534-5997
Practice Address - Fax:704-230-1397
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical