Provider Demographics
NPI:1659598266
Name:GREENE, ALLEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:GREENE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 HENDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5348
Mailing Address - Country:US
Mailing Address - Phone:252-636-1071
Mailing Address - Fax:
Practice Address - Street 1:2901 N. HERITAGE ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-0000
Practice Address - Country:US
Practice Address - Phone:252-522-9611
Practice Address - Fax:252-520-9601
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0001971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical