Provider Demographics
NPI:1275895435
Name:GREENE, AMY MELISSA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MELISSA
Last Name:GREENE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MELISSA
Other - Last Name:DUZAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7800 IOWA DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-4030
Mailing Address - Country:US
Mailing Address - Phone:501-804-6537
Mailing Address - Fax:
Practice Address - Street 1:329 NC 4526
Practice Address - Street 2:
Practice Address - City:MOUNT JUDEA
Practice Address - State:AR
Practice Address - Zip Code:72655-4024
Practice Address - Country:US
Practice Address - Phone:501-902-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AR6609-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health