Provider Demographics
NPI:1629473244
Name:GRECO, JOSEPH (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:GRECO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:GRECO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:175 WOLF HILL RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1340
Mailing Address - Country:US
Mailing Address - Phone:631-271-0913
Mailing Address - Fax:631-271-0914
Practice Address - Street 1:175 WOLF HILL RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1340
Practice Address - Country:US
Practice Address - Phone:631-271-0913
Practice Address - Fax:631-271-0914
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005228-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health