Provider Demographics
NPI:1376822338
Name:GREENLEAF, ERIN (MED, LMFT, LMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GREENLEAF
Suffix:
Gender:F
Credentials:MED, LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SOUTH MAIN STREET
Mailing Address - Street 2:BOX 419
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067
Mailing Address - Country:US
Mailing Address - Phone:617-483-0045
Mailing Address - Fax:
Practice Address - Street 1:36 S MAIN ST
Practice Address - Street 2:BOX 419
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1936
Practice Address - Country:US
Practice Address - Phone:617-483-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9006101YM0800X
MA1511106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist