Provider Demographics
NPI:1194970673
Name:GREENE, WILLIAM (ACDP)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:GREENE
Suffix:
Gender:M
Credentials:ACDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 HAMLET AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4423
Mailing Address - Country:US
Mailing Address - Phone:401-765-4040
Mailing Address - Fax:401-658-3757
Practice Address - Street 1:58 HAMLET AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4423
Practice Address - Country:US
Practice Address - Phone:401-765-4040
Practice Address - Fax:401-658-3757
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid