Provider Demographics
NPI:1508995804
Name:GREEN, HOPE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:HOPE
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2156
Mailing Address - Country:US
Mailing Address - Phone:708-299-4378
Mailing Address - Fax:708-310-6056
Practice Address - Street 1:16643 KEDZIE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MARKHAM
Practice Address - State:IL
Practice Address - Zip Code:60428-5512
Practice Address - Country:US
Practice Address - Phone:708-299-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490071691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical