Provider Demographics
NPI:1548709892
Name:GREENE, LINDSAY ALEXIS (RCSWI)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ALEXIS
Last Name:GREENE
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 NW 2ND AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6763
Mailing Address - Country:US
Mailing Address - Phone:561-715-5910
Mailing Address - Fax:561-892-0268
Practice Address - Street 1:2290 NW 2ND AVE
Practice Address - Street 2:STE 3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6763
Practice Address - Country:US
Practice Address - Phone:561-715-5910
Practice Address - Fax:561-892-0268
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW113191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLISW11319OtherFLORIAD DEPARTMENT OF HEALTH