Individual
JAMES W. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
47 MAIN ST, SUITE 230, BANGOR, ME 04401-6330
(207) 941-1663
(207) 941-0077
Mailing address
47 MAIN ST, SUITE 230, BANGOR, ME 04401-6330
(207) 941-1663
(207) 941-0077
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5061
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220130099
—
ME
Enumeration date
08/05/2006
Last updated
12/21/2012
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