Organization
GINNY GREEN LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA KAY GREEN LCSW (OWNER)
(505) 975-3498
Entity
Organization
Contact information
Practice address
100 SUN AVE NE STE 650, ALBUQUERQUE, NM 87109-4670
(505) 975-3498
Mailing address
PO BOX 67257, ALBUQUERQUE, NM 87193-7257
(505) 975-3498
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16088531
—
NM
Enumeration date
08/11/2019
Last updated
08/11/2019
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