Greene, Kelly Kathleen

Greene, Kelly Kathleen is an individual health care provider with primary practice located at 701 Us Highway 31 S , Traverse City MI 49685-8016. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Greene, Kelly Kathleen can be contacted via phone (989) 497-2500.

Contact Information

Primary practice address
701 Us Highway 31 S Traverse City MI 49685-8016
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6301011602 Michigan
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 6301011602 Michigan

Profile Details

NPI number 1508810318
LBN Legal business name Greene, Kelly Kathleen
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Feb 28th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508810318 NPPES
Michigan MEDICAID 1508810318

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