Individual
KERRY M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
250 NORTHWEST BLVD STE 101A, COEUR D ALENE, ID 83814-2971
(208) 661-9200
Mailing address
250 NORTHWEST BLVD STE 101A, COEUR D ALENE, ID 83814-2971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC-7253
ID
101YM0800X
Mental Health Counselor
Primary
LCPC-7253
ID
Other
Enumeration date
08/27/2019
Last updated
07/22/2025
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