Clay Sheldon Green, L.P.C.
Individual provider Active NPI Professional Counselor · Hawthorn Woods, IL
NPI 1609113802 · NPPES record last updated Jan 8, 2013
Key facts
- NPI
- 1609113802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.008572 (IL)
- Practice address
- 3 Westwind CT
Hawthorn Woods, IL 60047-7700 - Phone
- (224) 456-3057
- NPI assigned
- Jan 8, 2013
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 178.008572 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.008572 | IL | Yes |
Addresses
Primary practice location
3 Westwind CT
Hawthorn Woods, IL 60047-7700
Mailing address
3 Westwind CT
Hawthorn Woods, IL 60047-7700
Phone (224) 456-3057
Other providers in Hawthorn Woods, IL
- Magdalena Curylo
- Dental Professionals of Illinois, P.C.
- John C Edgar
- Magdalena Gajowniczek
- Charles Lowell Goodall
- Jamie Greenstein
- Lauren Gregorcy
- Hawthorn Woods Family Eye Care Inc.
- Cheryl Lynnette Hook
- Prathi H Jain
All providers in Hawthorn Woods, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2013. 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.