Individual
CHRISTOPHER WINSLOW GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2205 N IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 783-1267
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 415-0299
(208) 625-2070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
38470
ID
1041C0700X
Clinical Social Worker
Primary
41618
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255756730
—
ID
Enumeration date
04/01/2019
Last updated
03/04/2025
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