Basic Information
| Provider Information | |||||||||
| NPI: | 1851834931 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREEN | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ELAINE | ||||||||
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| Credential: | MSW, LCSW-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 REX DR | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287778360 | ||||||||
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| Practice Location | |||||||||
| Address1: | 119 TUNNEL RD STE D | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288051800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283501000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2016 | ||||||||
| LastUpdateDate: | 11/22/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | P011101 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.