Provider Demographics
NPI:1801173646
Name:GREENE, LANA DANIELLE (MA, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:LANA
Middle Name:DANIELLE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 STATION WAY
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-6343
Mailing Address - Country:US
Mailing Address - Phone:678-469-0349
Mailing Address - Fax:770-773-1500
Practice Address - Street 1:9876 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3970
Practice Address - Country:US
Practice Address - Phone:770-516-1050
Practice Address - Fax:770-516-1300
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional