Provider Information for 1942494463
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CARLISLE GREAVES LCSW-C
Sex: Male
NPI: 1942494463
Last Updated: 2022-01-12
Certification Date: 2022-01-12
Certification Date: 2022-01-12
Details
Name | Value | ||||||||
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NPI | 1942494463 | ||||||||
Enumeration Date | 2007-08-28 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 10300 VISTA HOLLOW WAY LANHAM, MD 20706-2895 United States Phone: 240-210-6613 | Fax: | ||||||||
Primary Practice Address | 10300 VISTA HOLLOW WAY LANHAM, MD 20706-2895 United States Phone: 240-210-6613 | Fax: | ||||||||
Secondary Practice Address(es) | 9500 MEDICAL CENTER DR STE 420 | ||||||||
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