Provider Demographics
NPI:1689750440
Name:GREINER, BEVERLY A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:A
Last Name:GREINER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 50TH ST
Mailing Address - Street 2:STE. 400
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4132
Mailing Address - Country:US
Mailing Address - Phone:806-698-8088
Mailing Address - Fax:806-698-8588
Practice Address - Street 1:3106 50TH ST
Practice Address - Street 2:STE. 400
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4132
Practice Address - Country:US
Practice Address - Phone:806-698-8088
Practice Address - Fax:806-698-8588
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS129621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114044100OtherFIRST CARE
TX87265QOtherBC/BS
TX0639692-03Medicaid
TXP00302165OtherRR MEDICARE
TX114044100OtherFIRST CARE