Provider Demographics
NPI:1467505487
Name:GREENSTONE, JAMES LYNN (EDD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LYNN
Last Name:GREENSTONE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W 4TH ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3978
Mailing Address - Country:US
Mailing Address - Phone:817-882-9415
Mailing Address - Fax:
Practice Address - Street 1:222 W 4TH ST
Practice Address - Street 2:SUITE 212
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3978
Practice Address - Country:US
Practice Address - Phone:817-882-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652106H00000X
TX3722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist