Provider Demographics
NPI:1780109058
Name:KOZEY GREENE, SHARON (LPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:KOZEY 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 1:21 HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-1507
Mailing Address - Country:US
Mailing Address - Phone:860-684-4239
Mailing Address - Fax:860-684-0511
Practice Address - Street 1:21 HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:STAFFORD SPRINGS
Practice Address - State:CT
Practice Address - Zip Code:06076-1507
Practice Address - Country:US
Practice Address - Phone:860-684-4239
Practice Address - Fax:860-684-0511
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty