Individual
JACQUELINE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
Mailing address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.189225
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/18/2022
Last updated
06/10/2025
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