Provider Demographics
NPI:1518163468
Name:GREENE, BARBARA B (PHD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:B
Last Name:GREENE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HAWTHORN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-3419
Mailing Address - Country:US
Mailing Address - Phone:508-996-6060
Mailing Address - Fax:508-993-9377
Practice Address - Street 1:49 HAWTHORN ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3419
Practice Address - Country:US
Practice Address - Phone:508-996-6060
Practice Address - Fax:508-993-9377
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2047501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB51011Medicare ID - Type Unspecified