Provider Demographics
NPI:1225261183
Name:GREEN, DIONNE RENEE (MA LPC)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:RENEE
Last Name:GREEN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 274
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-0274
Mailing Address - Country:US
Mailing Address - Phone:248-520-1231
Mailing Address - Fax:844-270-7373
Practice Address - Street 1:100 W BIG BEAVER RD STE 200
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5283
Practice Address - Country:US
Practice Address - Phone:248-520-1231
Practice Address - Fax:844-270-7373
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2025-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI6401009942261QM0850X, 101YP2500X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional