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Individual

ERIC TODD GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC CSAC

Contact information

Practice address
43 CHAMPIONS AVENUE, BIG STONE GAP, VA 24219
(276) 523-8300
(423) 467-3644
Mailing address
1167 SPRATLIN PARK DRIVE, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701003240 LPC
VA
101Y00000X
Counselor
0710101620 CSAC
VA
101YP2500X
Professional Counselor
Primary
0701003240
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010149614
VA
Enumeration date
02/02/2007
Last updated
10/14/2019
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