Provider Demographics
NPI:1669049797
Name:GREENE, COURTLYN TAYLOR (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:COURTLYN
Middle Name:TAYLOR
Last Name:GREENE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12716 SWEET BAY DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3439
Mailing Address - Country:US
Mailing Address - Phone:409-617-8726
Mailing Address - Fax:
Practice Address - Street 1:4144 N CENTRAL EXPY STE 850
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3226
Practice Address - Country:US
Practice Address - Phone:469-213-8928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82688101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional