Provider Demographics
NPI:1063741239
Name:GREENE, CARA T (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:T
Last Name:GREENE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 HARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4706
Mailing Address - Country:US
Mailing Address - Phone:516-944-6789
Mailing Address - Fax:516-944-8787
Practice Address - Street 1:259 HARBOR VIEW DR
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4706
Practice Address - Country:US
Practice Address - Phone:516-944-6789
Practice Address - Fax:516-944-8787
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO38637-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical