Provider Demographics
NPI:1275692436
Name:GREELEY, CAROL JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:GREELEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 HINMAN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-1838
Mailing Address - Country:US
Mailing Address - Phone:203-267-5266
Mailing Address - Fax:
Practice Address - Street 1:100 COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3098
Practice Address - Country:US
Practice Address - Phone:860-482-8561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional