Individual provider · NPI-1

Keisha Mclean-Green, CCS, LCAS, MAC, LPC

Counselor, Addiction (Substance Use Disorder) · Charlotte, NC

NPI number1992129266
StatusActive
Last updated in NPPESJul 6, 2019

Details

NPI
1992129266
Entity type
Individual (NPI-1)
Name
Keisha Mclean-Green
Credential
CCS, LCAS, MAC, LPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 7, 2014
Last updated
Jul 6, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)1828NCYes
101Y00000X Counselor12321NC
101YM0800X Counselor, Mental Health12321NC
101YP2500X Counselor, Professional12321NC
225C00000X Rehabilitation Counselor00102070IL

Practice location

1977 J N Pease Pl Ste 104
Charlotte, NC 28262-4528

Phone 704-215-4095 · Fax 704-271-1559

Mailing address

1977 J N Pease Pl Ste 104
Charlotte, NC 28262-4528

Phone 917-975-2675 · Fax 704-271-1559

Other practice locations

51 Union St S
Concord, NC 28025-5009

Phone 704-215-4095 · Fax 704-271-1559

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