Individual provider · Type 1 NPI

Gregory Malcom Green Sr., LPC

Mental Health Counselor · Bloomfield, CT

NPI number 1861147902 Active

Practice location

701 Cottage Grove Rd
Bloomfield, CT 06002-3080

Call (860) 209-0625 Map

Mailing address

141 Fieldstone Dr
Windsor, CT 06095-1663

Other practice locations

  • 141 Fieldstone Drive, Windsor, CT 06095 · (857) 636-0470

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X005313 (CT)
Mental Health Counselor 101YM0800XNone listed
Mental Health Counselor Primary 101YM0800X5313 (CT)

Mental Health Counselor: Definition to come...

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About NPI 1861147902

Gregory Malcom Green Sr., LPC's National Provider Identifier is 1861147902, issued on Feb 17, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bloomfield, CT. The record was last updated on Nov 20, 2023.