Provider Demographics
NPI:1184940579
Name:GREENE, AINA MALIKA VERONICA (LCMHC)
Entity type:Individual
Prefix:
First Name:AINA
Middle Name:MALIKA VERONICA
Last Name:GREENE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:AINA
Other - Middle Name:
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9929 REA RD STE 201
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-6439
Practice Address - Country:US
Practice Address - Phone:704-316-1650
Practice Address - Fax:704-316-1651
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-11
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7849101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional