Provider Demographics
NPI:1346383569
Name:PETERS, GREER GREER (LMHC)
Entity Type:Individual
Prefix:
First Name:GREER
Middle Name:GREER
Last Name:PETERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 E COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605
Mailing Address - Country:US
Mailing Address - Phone:813-382-4359
Mailing Address - Fax:813-662-1595
Practice Address - Street 1:4422 E COLUMBUS DR.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605
Practice Address - Country:US
Practice Address - Phone:813-382-4359
Practice Address - Fax:813-662-1595
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3455101YM0800X
FL1759101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL765704800Medicaid