Lisette Greene
Individual provider Active NPI Behavior Technician · Shalimar, FL
NPI 1578054292 · NPPES record last updated May 29, 2018
Key facts
- NPI
- 1578054292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 51 3Rd St BLDG 11
Shalimar, FL 32579-1700 - Phone
- (850) 420-2498
- NPI assigned
- May 29, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Florida Behavioral Consultants | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
51 3Rd St BLDG 11
Shalimar, FL 32579-1700
Mailing address
36 Walnut Ave
Shalimar, FL 32579-1120
Phone (850) 420-2498
Other practice location 1
36 Walnut Ave
Shalimar, FL 32579-1120
Phone (850) 420-2498
Other providers in Shalimar, FL
- Kathleen Galarza
- Jameson Galyon
- Howard Gillis
- Rebecca Kerry Gilpatrick
- Joselyne Stephanie Gonzalez Betancourt
- David John Hanle
- Healix Rehab LLC
- Jayden Isaac Heringer
- Holly Ward, M.D.
- Ashley Nicole Jollie
All providers in Shalimar, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.