Provider Demographics
NPI:1801166905
Name:GREENSPON, ARTHUR (LADC)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:GREENSPON
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LAKE WIND RD
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-2521
Mailing Address - Country:US
Mailing Address - Phone:203-801-3956
Mailing Address - Fax:
Practice Address - Street 1:111 LAKE WIND RD
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-2521
Practice Address - Country:US
Practice Address - Phone:203-801-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000962101YA0400X
NY084504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker