Provider Demographics
NPI:1972737401
Name:GREENE, CHELSEA ELIZABETH (MASTERS DEGREE PSYCH)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:ELIZABETH
Last Name:GREENE
Suffix:
Gender:F
Credentials:MASTERS DEGREE PSYCH
Other - Prefix:MS
Other - First Name:CHELSEA
Other - Middle Name:ELIZABETH
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASTERS DEGREE COUNS
Mailing Address - Street 1:1851 W EHRINGHAUS ST STE 180
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4555
Mailing Address - Country:US
Mailing Address - Phone:910-585-3407
Mailing Address - Fax:910-585-3407
Practice Address - Street 1:1851 W EHRINGHAUS ST STE 180
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4555
Practice Address - Country:US
Practice Address - Phone:910-585-3407
Practice Address - Fax:910-585-3407
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health