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Provider Information for 1790293736

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

CHANTAL NAIMMA GREEN LMHC

Other Name:   CHANTAL KAMARA
Gender: FEMALE

Individual NPI: 1790293736

Calendar   Last Updated:  2018-01-11
  Certification Date: 

Details

Name Value
NPI 1790293736
Enumeration Date 2018-01-11
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 225 BROADWAY STE 3400
NEW YORK, NY 10007-3054
United States

Phone: 347-391-4250 | Fax:
View Map External Link
Primary Practice Address 225 BROADWAY STE 3400
NEW YORK, NY 10007-3054
United States

Phone: 347-391-4250 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 101YM0800X - Counselor Mental Health NY 008389