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Provider Information for 1942420740

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

MS. CECEILE MCINTOSH GREEN MS, PHD CANDIDATE

Other Name:   CECEILE MCINTOSH
Gender: FEMALE

Individual NPI: 1942420740

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1942420740
Enumeration Date 2007-04-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 10417 131ST ST SOUTH RICHMOND HILL
SOUTH RICHMOND HILL, NY 11419-3107
United States

Phone: 718-322-4831 | Fax: 718-322-4831
View Map External Link
Primary Practice Address 9001 MERRICK BLVD JAMAICA
JAMAICA, NY 11432-5244
United States

Phone: 718-523-4242 | 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