Provider Demographics
NPI:1699392563
Name:GREENBRIAR PSYCHOTHERAPY
Entity Type:Organization
Organization Name:GREENBRIAR PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TESS
Authorized Official - Middle Name:
Authorized Official - Last Name:HORENBLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-887-1133
Mailing Address - Street 1:516 FULLER AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3421
Mailing Address - Country:US
Mailing Address - Phone:503-887-1133
Mailing Address - Fax:
Practice Address - Street 1:516 FULLER AVE STE 1
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3421
Practice Address - Country:US
Practice Address - Phone:503-887-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty