Provider Demographics
NPI:1053108951
Name:GREEN SHORE COUNSELING PLLC
Entity type:Organization
Organization Name:GREEN SHORE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAESAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-378-7912
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-0413
Mailing Address - Country:US
Mailing Address - Phone:281-378-7912
Mailing Address - Fax:
Practice Address - Street 1:11803 GRANT RD STE 209
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4022
Practice Address - Country:US
Practice Address - Phone:281-378-7912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty