Jenise Tehvon Greene, | |
1808 Over Lake Dr Se Ste D, Conyers, GA 30013-6608 | |
(678) 213-2194 | |
Not Available |
Full Name | Jenise Tehvon Greene |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 1808 Over Lake Dr Se Ste D, Conyers, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255042495 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC013548 (Georgia) | Primary |
Entity Name | Personal Recovery Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096 |
Mailing Address | Practice Location Address |
---|---|
Jenise Tehvon Greene, 1808 Over Lake Dr Se Ste D, Conyers, GA 30013-6608 Ph: (404) 273-8504 | Jenise Tehvon Greene, 1808 Over Lake Dr Se Ste D, Conyers, GA 30013-6608 Ph: (678) 213-2194 |
Mr. Solomon Berewa, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1000 Iris Dr Sw Ste D200, Conyers, GA 30094 Phone: 404-396-7890 | |
Angel Jocelin Haye, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2365 Wall St Se Ste 200-04, Conyers, GA 30013 Phone: 404-890-0125 | |
Crystal N. Broughton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1775 Parker Rd Se Ste 210, Conyers, GA 30094 Phone: 470-967-8663 Fax: 678-218-4253 | |
Michelle M. Billups, Counselor Medicare: Not Enrolled in Medicare Practice Location: 977a Taylor St Sw, Conyers, GA 30012 Phone: 770-918-6677 | |
Dandrea R Sanders, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1780b Southgate Ln Se, Conyers, GA 30013 Phone: 470-207-2044 | |
Leroy Bryan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1175 Green St Se, Conyers, GA 30012 Phone: 770-929-1470 | |
Debra Lavette Hanson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3204 Quincey Xing, Conyers, GA 30013 Phone: 404-803-1127 |