Provider Demographics
NPI:1780891317
Name:GREENE, ABBY CAMERON (CRC, L MHC)
Entity type:Individual
Prefix:MS
First Name:ABBY
Middle Name:CAMERON
Last Name:GREENE
Suffix:
Gender:F
Credentials:CRC, L MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1216
Mailing Address - Country:US
Mailing Address - Phone:516-365-7126
Mailing Address - Fax:516-365-3687
Practice Address - Street 1:186 HEMLOCK RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1216
Practice Address - Country:US
Practice Address - Phone:516-365-7126
Practice Address - Fax:516-365-3687
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003319101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health