Individual
ELIZABETH R GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LMSW, QMHP-C
Contact information
Practice address
700 UNIVERSITY CITY BLVD, BLACKSBURG, VA 24060-2706
(540) 961-8300
Mailing address
700 UNIVERSITY CITY BLVD, BLACKSBURG, VA 24060-2706
(540) 961-8300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.121484
OH
104100000X
Social Worker
0903002937
VA
1041C0700X
Clinical Social Worker
Primary
0904014583
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2374229
—
OH
Enumeration date
09/19/2014
Last updated
12/01/2022
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