Provider Demographics
NPI:1710443882
Name:GREEN, KAREN D (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:GREEN
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 1:923 E 217TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-1002
Mailing Address - Country:US
Mailing Address - Phone:347-389-3037
Mailing Address - Fax:
Practice Address - Street 1:923 E 217TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-1002
Practice Address - Country:US
Practice Address - Phone:347-389-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist