Provider Demographics
NPI:1629235874
Name:GREEN, FRANK E (MA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:E
Last Name:GREEN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-0597
Mailing Address - Country:US
Mailing Address - Phone:877-907-7970
Mailing Address - Fax:
Practice Address - Street 1:7930 NITTANY VALLEY DR
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-8805
Practice Address - Country:US
Practice Address - Phone:877-907-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health