Provider Demographics
NPI:1467464370
Name:GREEN-JOSOFF, REENA FAYE (LCSW)
Entity Type:Individual
Prefix:
First Name:REENA
Middle Name:FAYE
Last Name:GREEN-JOSOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 N HARRISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84404-3537
Mailing Address - Country:US
Mailing Address - Phone:801-399-1818
Mailing Address - Fax:801-782-8412
Practice Address - Street 1:811 N HARRISVILLE RD
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:UT
Practice Address - Zip Code:84404-3537
Practice Address - Country:US
Practice Address - Phone:013-991-8188
Practice Address - Fax:801-782-8412
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-267921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical