Individual
BRIAN H GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6720 S ZEPHYR WAY, BOISE, ID 83709-5383
(208) 409-5816
Mailing address
6720 S ZEPHYR WAY, BOISE, ID 83709-5383
(208) 287-0993
(208) 287-0996
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
LCSW1099
ID
Other
Enumeration date
02/22/2007
Last updated
12/28/2020
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