Robert A Green, LPC

Individual provider Active NPI Professional Counselor · Darien, GA

NPI 1255528014 · NPPES record last updated Sep 26, 2007

Key facts

NPI
1255528014
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC004870 (GA)
Practice address
1000 Commissioner Dr
Darien, GA 31305-9487
Phone
(912) 437-7300
Fax
(912) 437-9481
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC004870GAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC004870 GA Yes

Addresses

Primary practice location

1000 Commissioner Dr
Darien, GA 31305-9487

Mailing address

1000 Commissioner Dr
Darien, GA 31305-9487
Phone (912) 437-7300

Other identifiers

IdentifierTypeStateIssuer
LPC004870OtherGASTATE LICENSE NUMBER

Other providers in Darien, GA

All providers in Darien, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.