Provider Demographics
NPI:1821679887
Name:GREENBERG, EMILY (PLCSW, PLMHP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:PLCSW, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1817
Mailing Address - Country:US
Mailing Address - Phone:531-299-3735
Mailing Address - Fax:
Practice Address - Street 1:4519 S 24TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1817
Practice Address - Country:US
Practice Address - Phone:531-299-3735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE122911041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool