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Ida Lawanda Green
Counselor in Novato, California
NPI 1841573151

Ida Lawanda Green is a Counselor based in Novato, CA. Ida Lawanda Green practices in Novato, CA. The NPI Number for Ida Lawanda Green is 1841573151 and holds a License No. ASW79071 (California).

The current practice location address for Ida Lawanda Green is 1682 Novato Blvd Ste 105, Novato, CA and can be reached out via phone at 415-454-2152.

Location: 1682 Novato Blvd Ste 105, Novato, CA, 94947-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841573151
Provider Name
Ida Lawanda Green
Credential
Provider Entity Type
Individual
Gender
Female
Address
1682 Novato Blvd Ste 105, Novato, CA, 94947-0001
Phone Number
415-454-2152
Fax Number
Provider Enumeration Date
09/22/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1682 Novato Blvd Ste 105
City
Novato
State
California
Zip
94947-0001
Phone Number
415-454-2152
Fax Number
person
Provider Business Mailing Address Details
Address
1682 Novato Blvd Ste 105
City
Novato
State
California
Zip
94947-0001
Phone Number
415-454-2152
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
ASW79071 (California)
Definition
Definition to come...
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