Provider Demographics
NPI:1497084339
Name:GRECO, NEIL ALLEN (MSW)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:ALLEN
Last Name:GRECO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 MARSHALL AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6092
Mailing Address - Country:US
Mailing Address - Phone:619-961-6692
Mailing Address - Fax:
Practice Address - Street 1:2233 HAMLINE AVE N STE 435
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-5023
Practice Address - Country:US
Practice Address - Phone:612-708-7712
Practice Address - Fax:651-846-4899
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN27-1517082OtherEIN