Provider Demographics
NPI:1972191526
Name:GREEN COUNSELING & ASSOCIATES
Entity Type:Organization
Organization Name:GREEN COUNSELING & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRACTICTIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-886-0150
Mailing Address - Street 1:540 US 31
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-3052
Mailing Address - Country:US
Mailing Address - Phone:317-886-0150
Mailing Address - Fax:
Practice Address - Street 1:540 US 31
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-3052
Practice Address - Country:US
Practice Address - Phone:317-886-0150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty