Provider Demographics
NPI:1154649416
Name:GREEN, ALICE ELIZABETH (LPC-S, ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:ELIZABETH
Last Name:GREEN
Suffix:
Gender:F
Credentials:LPC-S, ATR-BC
Other - Prefix:
Other - First Name:BESS
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-S, ATR-BC
Mailing Address - Street 1:1101 ARROW POINT DR STE 207
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7739
Mailing Address - Country:US
Mailing Address - Phone:512-636-9838
Mailing Address - Fax:512-986-7161
Practice Address - Street 1:1101 ARROW POINT DR STE 207
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7739
Practice Address - Country:US
Practice Address - Phone:512-636-9838
Practice Address - Fax:512-986-7161
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15229101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional