Individual
BRENDA R GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, APHSW-C
Contact information
Practice address
576 GENESEE AVE, STATEN ISLAND, NY 10312-3121
(917) 734-9294
Mailing address
576 GENESEE AVE, STATEN ISLAND, NY 10312-3121
(917) 734-9294
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
091065
NY
1041C0700X
Clinical Social Worker
091065-01
NY
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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