Individual
MS. FREIDA LOUISE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCAS, NCC
Contact information
Practice address
5602 GLENROCK DR, FAYETTEVILLE, NC 28303-6005
(910) 705-0631
Mailing address
5602 GLENROCK DR, FAYETTEVILLE, NC 28303-6005
(910) 705-0631
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
72715
NC
101YM0800X
Mental Health Counselor
Primary
4421
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140JU
BLUE CROSS BLUE SHIELD
NC
05
—
6102788
—
NC
Enumeration date
06/26/2007
Last updated
01/27/2014
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