Provider Demographics
NPI:1598780595
Name:GREENSTEIN, BETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:GREENSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:FOWLER-GREENSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1800 N FEDERAL HIGHWAY
Mailing Address - Street 2:SUITE 207 C/O LITZERIS MEDICAL CENTER
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:954-298-8048
Mailing Address - Fax:954-781-2291
Practice Address - Street 1:1800 N FEDERAL HIGHWAY
Practice Address - Street 2:SUITE 207, C/O LINTZERIS MEDICAL CENTER
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062
Practice Address - Country:US
Practice Address - Phone:954-298-8048
Practice Address - Fax:954-781-2291
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW36281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP62914Medicare UPIN
FLZ6959Medicare ID - Type UnspecifiedPROVIDER NUMBER
FLK6959Medicare ID - Type UnspecifiedMEDICARE SENDER NUMBER