Provider Demographics
NPI:1689039695
Name:GREENHOUSE, CARMEN (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:GREENHOUSE
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-3022
Mailing Address - Country:US
Mailing Address - Phone:318-305-4853
Mailing Address - Fax:
Practice Address - Street 1:104 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-3022
Practice Address - Country:US
Practice Address - Phone:318-305-4853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1260106H00000X
LA5973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist