| Ginny Green Lcsw Llc | |
|
100 Sun Ave Ne Ste 650 Albuquerque NM 87109-4670 | |
| (505) 975-3498 | |
| Not Available |
| Full Name | Ginny Green Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 100 Sun Ave Ne Ste 650, Albuquerque, New Mexico |
| Authorized Official Name and Position | Virginia Kay Green (OWNER) |
| Authorized Official Contact | 5059753498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ginny Green Lcsw Llc Po Box 67257 Albuquerque NM 87193-7257 Ph: (505) 975-3498 | Ginny Green Lcsw Llc 100 Sun Ave Ne Ste 650 Albuquerque NM 87109-4670 Ph: (505) 975-3498 |
| NPI Number | 1720634330 |
|---|---|
| Provider Enumeration Date | 08/11/2019 |
| Last Update Date | 08/11/2019 |
| Medicare PECOS PAC ID | 7719303122 |
|---|---|
| Medicare Enrollment ID | O20200817001247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720634330 | NPI | - | NPPES |
| 16088531 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Virginia Kay Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679500318 PECOS PAC ID: 4385640622 Enrollment ID: I20061010000719 |
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