Provider Demographics
NPI:1316308414
Name:GREENE, NAKEESHIA ESSEX
Entity type:Individual
Prefix:MISS
First Name:NAKEESHIA
Middle Name:ESSEX
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-2504
Mailing Address - Country:US
Mailing Address - Phone:610-741-3007
Mailing Address - Fax:
Practice Address - Street 1:15 N 6TH ST # 303
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3505
Practice Address - Country:US
Practice Address - Phone:610-774-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA135053101Y00000X
101Y00000X
PACW0219591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor