Provider Demographics
NPI:1720231269
Name:GREENBERG, MARC A (LCSW)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:A
Last Name:GREENBERG
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 1:907 NE 2ND CT
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3588
Mailing Address - Country:US
Mailing Address - Phone:954-652-9936
Mailing Address - Fax:
Practice Address - Street 1:907 NE 2ND CT
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3588
Practice Address - Country:US
Practice Address - Phone:954-652-9936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW91361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical