Provider Demographics
NPI:1558149062
Name:GREENE, BETH H (MSW, LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:H
Last Name:GREENE
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:H
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWA
Mailing Address - Street 1:2335 POCOMOKE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-8841
Mailing Address - Country:US
Mailing Address - Phone:919-497-2366
Mailing Address - Fax:
Practice Address - Street 1:1013 BULLARD CT STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6801
Practice Address - Country:US
Practice Address - Phone:919-583-7910
Practice Address - Fax:919-278-2647
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0197471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical