Individual
EMILY E GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-5961
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-5961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19778
WI
1041C0700X
Clinical Social Worker
Primary
132496
WI
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/01/2021
Last updated
05/05/2023
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