Provider Demographics
NPI:1811876501
Name:GREEN, ALISON LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LYNN
Last Name:GREEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 HOLTON WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461-9110
Mailing Address - Country:US
Mailing Address - Phone:574-261-9265
Mailing Address - Fax:
Practice Address - Street 1:1075 HOLTON WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MI
Practice Address - Zip Code:49461-9110
Practice Address - Country:US
Practice Address - Phone:574-261-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010922991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical