Individual
JUDITH GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
2 MASCIO DR, JOHNSTON, RI 02919-5913
(401) 464-9260
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00085
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000030458
BLUE CROSS
RI
01
—
407888
BLUE CHIP
RI
01
—
6205586
UNITED HEALTH
RI
05
—
JG44180
—
RI
Enumeration date
07/16/2006
Last updated
02/03/2011
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