Provider Demographics
NPI:1376883637
Name:GREEN, ZEBRENA DENISE (MSW)
Entity Type:Individual
Prefix:
First Name:ZEBRENA
Middle Name:DENISE
Last Name:GREEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2467 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-3041
Mailing Address - Country:US
Mailing Address - Phone:561-856-3771
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 36TH STREEET
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33416-3807
Practice Address - Country:US
Practice Address - Phone:866-305-7365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health