Provider Demographics
NPI:1457687360
Name:GREENSTEIN, MARTIN H (LICSW)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:H
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HOSPITAL AVENUE
Mailing Address - Street 2:NORTH ADAMS REGIONAL HOSPITAL
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2504
Mailing Address - Country:US
Mailing Address - Phone:413-664-5000
Mailing Address - Fax:413-664-5164
Practice Address - Street 1:71 HOSPITAL AVENUE
Practice Address - Street 2:NORTH ADAMS REGIONAL HOSPITAL
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2504
Practice Address - Country:US
Practice Address - Phone:413-664-5000
Practice Address - Fax:413-664-5164
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107370101Y00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY10035Medicare UPIN