Provider Demographics
NPI:1851834931
Name:GREEN, KATHERINE ELAINE (MSW, LCSW-A)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELAINE
Last Name:GREEN
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 REX DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2938
Mailing Address - Country:US
Mailing Address - Phone:828-777-8360
Mailing Address - Fax:
Practice Address - Street 1:119 TUNNEL RD STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1800
Practice Address - Country:US
Practice Address - Phone:828-350-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0111011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical