Provider Demographics
NPI:1205130093
Name:SELIGMAN GREENE, NANETTE ROSE (LPC)
Entity type:Individual
Prefix:MS
First Name:NANETTE
Middle Name:ROSE
Last Name:SELIGMAN GREENE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-1705
Mailing Address - Country:US
Mailing Address - Phone:203-615-3894
Mailing Address - Fax:
Practice Address - Street 1:374 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-1705
Practice Address - Country:US
Practice Address - Phone:203-615-3894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health