Provider Demographics
NPI:1235849696
Name:GREENE, VICTORIA (QMHP-C, MFT RESIDENT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:QMHP-C, MFT RESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 LOCKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2626
Mailing Address - Country:US
Mailing Address - Phone:267-283-0789
Mailing Address - Fax:
Practice Address - Street 1:1532 LOCKEWOOD DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2626
Practice Address - Country:US
Practice Address - Phone:267-283-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist