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Antonette Marie Green, LPC

Counselor, Professional in Swansea, IL. Individual provider (NPI-1).

NPI number1023719085
StatusActive
Last updated in NPPESMar 15, 2023

Details

NPI
1023719085
Entity type
Individual (NPI-1)
Name
Mrs. Antonette Marie Green
Credential
LPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 15, 2023
Certification date
Mar 15, 2023
Last updated
Mar 15, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional178.017413ILYes

Practice location

2 Bronze Pointe S Ste A
Swansea, IL 62226-8307

Phone 618-207-2547

Mailing address

205 Hickory Rdg
Belleville, IL 62223-3443

Phone 618-593-4626

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