Individual
MRS. CARRY L GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LMHP LPC
Contact information
Practice address
9014 S CENTRAL AVE, PHOENIX, AZ 85042-8304
(602) 230-7373
(602) 230-5105
Mailing address
3620 N 3RD ST, PHOENIX, AZ 85012-2020
(602) 230-7373
(602) 230-5105
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2389
NE
101YP2500X
Professional Counselor
1316
NE
101YP2500X
Professional Counselor
Primary
LPC-17306
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
234934
MIDLANDS CHOICE
NE
01
—
84002
BLUE CROSS BLUE SHIELD
NE
Enumeration date
12/05/2006
Last updated
09/15/2020
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