person
Gregory Malcom Green SR., LPC
Mental Health Counselor in Bloomfield, Connecticut
NPI 1861147902

Gregory Malcom Green SR. is a Mental Health Counselor based in Windsor, CT and is specialized in Mental Health. Gregory Malcom Green SR. practices in Bloomfield, CT and has the professional credentials of LPC. The NPI Number for Gregory Malcom Green SR. is 1861147902 and holds a License No. 005313 (Connecticut).

The current practice location address for Gregory Malcom Green SR. is 701 Cottage Grove Rd, Bloomfield, CT and can be reached out via phone at 860-209-0625.

Location: 701 Cottage Grove Rd, Bloomfield, CT, 06095-1663
person
Provider Profile Details
NPI Number
1861147902
Provider Name
Gregory Malcom Green SR.
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
701 Cottage Grove Rd, Bloomfield, CT, 06095-1663
Phone Number
860-209-0625
Fax Number
Provider Enumeration Date
02/17/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
701 Cottage Grove Rd
City
State
Zip
06002-3080
Phone Number
860-209-0625
Fax Number
person
Provider Business Mailing Address Details
Address
701 Cottage Grove Rd
City
State
Zip
06002-3080
Phone Number
860-209-0625
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
005313 (Connecticut)
Definition
Definition to come...
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