| Dr Cornelia Ellis Green, PHD | |
| 
					419 Pleasant St, Suite 313, Beloit, WI 53511-6249  | |
| (608) 365-7078 | |
| (608) 365-7464 | 
| Full Name | Dr Cornelia Ellis Green | 
|---|---|
| Gender | Female | 
| Speciality | Psychologist - Counseling | 
| Location | 419 Pleasant St, Beloit, Wisconsin | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1023162468 | NPI | - | NPPES | 
| 39027300 | Medicaid | WI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 951-057 (Wisconsin) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Cornelia Ellis Green, PHD 419 Pleasant St, Suite 313, Beloit, WI 53511-6249 Ph: (608) 365-7078  | Dr Cornelia Ellis Green, PHD 419 Pleasant St, Suite 313, Beloit, WI 53511-6249 Ph: (608) 365-7078  | 
Savannah Marie Boyd,  Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1225 Emerson St, Beloit, WI 53511 Phone: 706-968-8879  | |
Keith D Gibson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1969 W Hart Rd, Beloit, WI 53511 Phone: 608-364-5686 Fax: 608-363-5756  |