Provider Demographics
NPI:1669501458
Name:GREENE, PAULA V (LPC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:V
Last Name: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 1:2700 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601-5587
Mailing Address - Country:US
Mailing Address - Phone:870-413-1894
Mailing Address - Fax:
Practice Address - Street 1:1000 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-5304
Practice Address - Country:US
Practice Address - Phone:870-413-2130
Practice Address - Fax:870-672-7010
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0609049101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor