Individual
MS. STACY KANEN-GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3712
(631) 920-8300
(631) 920-8460
Mailing address
7 WALKER AVE, SYOSSET, NY 11791-4028
(516) 884-2471
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12340
NY
1041C0700X
Clinical Social Worker
0444701
NY
Other
Enumeration date
08/13/2006
Last updated
09/11/2025
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