Provider Demographics
NPI:1154595007
Name:GREENE, CELESTE ROSE (LCPC)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:ROSE
Last Name:GREENE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 CHERRY LANE CT
Mailing Address - Street 2:SUITE 216
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4946
Mailing Address - Country:US
Mailing Address - Phone:301-490-1011
Mailing Address - Fax:301-490-1494
Practice Address - Street 1:14440 CHERRY LANE CT
Practice Address - Street 2:SUITE 216
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4946
Practice Address - Country:US
Practice Address - Phone:301-490-1011
Practice Address - Fax:301-490-1494
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health