Provider Demographics
NPI:1962604736
Name:GREENE, CHERYL A (MA)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:A
Last Name:GREENE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1A TIMBER WAY
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2562
Mailing Address - Country:US
Mailing Address - Phone:508-420-1511
Mailing Address - Fax:
Practice Address - Street 1:800 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6355
Practice Address - Country:US
Practice Address - Phone:508-994-0894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health