| Gary Green, | |
|
474 Allen Dr, Lawrenceville, GA 30043-3700 | |
| (678) 373-5059 | |
| Not Available |
| Full Name | Gary Green |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 474 Allen Dr, Lawrenceville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427532761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | APC005861 (Georgia) | Secondary |
| 101YP2500X | Counselor - Professional | LPC011779 (Georgia) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220315000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Green, 474 Allen Dr, Lawrenceville, GA 30043-3700 Ph: (678) 373-5059 | Gary Green, 474 Allen Dr, Lawrenceville, GA 30043-3700 Ph: (678) 373-5059 |
Ms. Katherine Anne Sturgis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 175 Gwinnett Dr, Lawrenceville, GA 30046 Phone: 678-209-2394 Fax: 678-212-6350 | |
John Troy Mcqueen, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 685 Rosedown Way, Lawrenceville, GA 30043 Phone: 678-925-4545 | |
Fatima Flynn, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 175 Gwinnett Dr, Lawrenceville, GA 30046 Phone: 678-209-2394 | |
Mrs. Christy Hall Wages, M.S., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 223 Scenic Hwy, Suite 100, Lawrenceville, GA 30045 Phone: 770-995-1846 Fax: 770-995-6614 | |
Angella Bramwell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 175 Gwinnett Dr, Lawrenceville, GA 30046 Phone: 770-339-2395 Fax: 678-990-3997 | |
Jenna Spears, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1026 Old Peachtree Rd Ne, Lawrenceville, GA 30043 Phone: 678-634-9237 | |
Dr. Latoya Smith, PHD Counselor Medicare: Not Enrolled in Medicare Practice Location: 1623 Vinings Ct, Lawrenceville, GA 30043 Phone: 954-732-8954 |