Provider Demographics
NPI:1780895508
Name:GREENE, CELESTE J (LMHC)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:J
Last Name:GREENE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 MENDON RD APT 8
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3442
Mailing Address - Country:US
Mailing Address - Phone:401-475-8051
Mailing Address - Fax:
Practice Address - Street 1:245 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3123
Practice Address - Country:US
Practice Address - Phone:401-766-0900
Practice Address - Fax:401-766-8737
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3072101YM0800X
RIMHC00085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health