Individual provider · Type 1 NPI

Stacie Diane Green

Mental Health Counselor · Philadelphia, PA

NPI number 1386972628 Active

Practice location

1315 Windrim Ave
Philadelphia, PA 19141-2710

Call (609) 502-8609 Map

Mailing address

42 Harwood Ln
Clementon, NJ 08021-3606

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1386972628

Stacie Diane Green's National Provider Identifier is 1386972628, issued on Nov 25, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Nov 25, 2009.