Provider Demographics
NPI:1558569947
Name:GREENE, CHRISTINE J (LPC 3885)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:J
Last Name:GREENE
Suffix:
Gender:F
Credentials:LPC 3885
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3627
Mailing Address - Country:US
Mailing Address - Phone:336-882-3800
Mailing Address - Fax:
Practice Address - Street 1:811 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3627
Practice Address - Country:US
Practice Address - Phone:336-882-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102244Medicaid