Provider Demographics
NPI:1083839567
Name:GREENE, JANET (EDS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:EDS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 SW 226TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3200
Mailing Address - Country:US
Mailing Address - Phone:352-472-7070
Mailing Address - Fax:352-472-9746
Practice Address - Street 1:25355 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3200
Practice Address - Country:US
Practice Address - Phone:352-472-7070
Practice Address - Fax:352-472-9746
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health