Provider Demographics
NPI:1295708824
Name:GREENE, GEORGEANNE (LCSW)
Entity type:Individual
Prefix:
First Name:GEORGEANNE
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 E. OLMOS #2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:210-829-4752
Mailing Address - Fax:
Practice Address - Street 1:BAMC DEPT OF SOCIAL WORK
Practice Address - Street 2:3851 ROGER BROOKE DRIVE
Practice Address - City:FT SAM HOUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:210-916-3020
Practice Address - Fax:210-916-1073
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX415281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical