Individual provider · Type 1 NPI

Jerry Wayne Green, LPC

Professional Counselor · Grand Prairie, TX

NPI number 1992361497 Active

Practice location

2463 Waterside Dr
Grand Prairie, TX 75054-6806

Call (817) 673-2183 Map

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X14932 (TX)

Professional Counselor: Definition to come...

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About NPI 1992361497

Jerry Wayne Green, LPC's National Provider Identifier is 1992361497, issued on May 10, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Grand Prairie, TX. The record was last updated on May 10, 2019.