Individual
MRS. KELLY ROBINSON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LPC, LISAC
Contact information
Practice address
5701 W TALAVI BLVD STE 180, GLENDALE, AZ 85306-1888
(623) 687-2865
(623) 486-2739
Mailing address
4747 N 7TH ST STE 100, PHOENIX, AZ 85014-3654
(602) 279-7655
(602) 680-1260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-1345
AZ
101YP2500X
Professional Counselor
Primary
LPC-11799
AZ
Other
Enumeration date
05/30/2011
Last updated
08/26/2022
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