Provider Demographics
NPI:1073059739
Name:GREENE, PATRICIA (LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1500 LAKE RD APT 8
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1321
Mailing Address - Country:US
Mailing Address - Phone:859-948-4470
Mailing Address - Fax:
Practice Address - Street 1:1616 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3660
Practice Address - Country:US
Practice Address - Phone:830-328-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68662101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional