Provider Demographics
NPI:1205641925
Name:L. L. GREEN AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:L. L. GREEN AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:LANEE
Authorized Official - Last Name:GREEN-BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LICSW, LMFT
Authorized Official - Phone:813-999-3001
Mailing Address - Street 1:2103 NUTTALL OAKS PL
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2179
Mailing Address - Country:US
Mailing Address - Phone:813-999-3001
Mailing Address - Fax:
Practice Address - Street 1:2103 NUTTALL OAKS PL
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2179
Practice Address - Country:US
Practice Address - Phone:813-999-3001
Practice Address - Fax:813-819-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist