Individual
JUSTIN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MACP, ACD, LPCC
Contact information
Practice address
1644 S COLLEGE AVE, FORT COLLINS, CO 80525-1007
(970) 221-0999
Mailing address
4515 HIBISCUS ST, FORT COLLINS, CO 80526-4137
(970) 460-6153
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2329
CO
101YP2500X
Professional Counselor
Primary
21372
CO
Other
Enumeration date
09/16/2022
Last updated
12/03/2024
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