Provider Demographics
NPI:1821282831
Name:GREENE, CARLA SCOTT (LMSW)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:SCOTT
Last Name:GREENE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8313
Mailing Address - Country:US
Mailing Address - Phone:843-884-3817
Mailing Address - Fax:
Practice Address - Street 1:551 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8313
Practice Address - Country:US
Practice Address - Phone:843-884-3817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-03
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical