Provider Demographics
NPI:1396772026
Name:GREENE, KAREN TORRY (DBH, LCSW)
Entity type:Individual
Prefix:
First Name:KAREN TORRY
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:DBH, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1894 E WILLIAM ST # 4-496
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-3224
Mailing Address - Country:US
Mailing Address - Phone:602-909-1710
Mailing Address - Fax:
Practice Address - Street 1:777 E WILLIAM ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-4056
Practice Address - Country:US
Practice Address - Phone:602-909-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1032901041C0700X
AZLCSW106531041C0700X
NV7579C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255591400OtherNPPES
11575602OtherCAQH
AZ838526Medicaid
NV250006318Medicaid