| Christopher Winslow Green, LCSW | |
|
109 E Harrison Ave, Coeur D Alene, ID 83814-3238 | |
| (208) 783-1267 | |
| Not Available |
| Full Name | Christopher Winslow Green |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 109 E Harrison Ave, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801358890 | NPI | - | NPPES |
| 1255756730 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 41618 (Idaho) | Primary |
| 104100000X | Social Worker | 38470 (Idaho) | Secondary |
| Entity Name | Dirne Health Centers, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285686477 PECOS PAC ID: 2466353354 Enrollment ID: O20050303001041 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Winslow Green, LCSW Po Box 1387, Hayden, ID 83835-1387 Ph: (208) 415-0299 | Christopher Winslow Green, LCSW 109 E Harrison Ave, Coeur D Alene, ID 83814-3238 Ph: (208) 783-1267 |
Donna Colberg, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6050 E Kingswood Ln, Coeur D Alene, ID 83814 Phone: 208-651-3948 | |
Deemarla Tavares, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2201 Ironwood Pl, Coeur D Alene, ID 83814 Phone: 208-769-4222 Fax: 208-667-7557 | |
Mr. Jud Eugene Leifheit, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1110 W Park Pl Ste 305, Coeur D Alene, ID 83814 Phone: 208-667-6606 Fax: 208-765-3051 | |
Wayne Bingham Timonen, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 7905 N Meadowlark Way, Suite C, Coeur D Alene, ID 83815 Phone: 208-762-3979 Fax: 208-762-4419 | |
Robert K Wyatt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 950 W Ironwood Dr, Suite #2, Coeur D Alene, ID 83814 Phone: 208-664-1594 Fax: 208-664-5867 | |
Laurie D Regan, LCSW 688 Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-666-2000 Fax: 208-666-3963 | |
Susan Helen Hennige, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2005 N Ironwood Pkwy Ste 113, Coeur D Alene, ID 83814 Phone: 208-758-8302 Fax: 208-758-0850 |