Individual
KEISHA MCLEAN-GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCS, LCAS, MAC, LPC
Contact information
Practice address
1977 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4528
(704) 215-4095
(704) 271-1559
Mailing address
1977 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4528
(917) 975-2675
(704) 271-1559
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
12321
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1828
NC
101YM0800X
Mental Health Counselor
12321
NC
101YP2500X
Professional Counselor
12321
NC
225C00000X
Rehabilitation Counselor
00102070
IL
Other
Enumeration date
02/07/2014
Last updated
07/06/2019
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