Provider Demographics
NPI:1609110501
Name:GREENE, ELIZABETH (LMHC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 STOCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1972
Mailing Address - Country:US
Mailing Address - Phone:413-212-9235
Mailing Address - Fax:
Practice Address - Street 1:401 STOCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1972
Practice Address - Country:US
Practice Address - Phone:413-212-9235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NY006174-1101YM0800X
MA8926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor