Organization
GREEN MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY GREEN LCSW (OWNER)
(405) 265-8565
Entity
Organization
Contact information
Practice address
14209 SW 50TH CT, YUKON, OK 73099-2800
(405) 265-8565
Mailing address
14209 SW 50TH CT, YUKON, OK 73099-2800
(405) 265-8565
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5684
LCSW LICENSE
OK
Enumeration date
05/19/2022
Last updated
05/19/2022
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