Green, Daryl

Green, Daryl is an individual health care provider with primary practice located at 1805 Florence Rd Suite 10, Killeen TX 76541-8523. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Green, Daryl can be contacted via phone (254) 526-5389.

Contact Information

Primary practice address
1805 Florence Rd Suite 10 Killeen TX 76541-8523
Phone: (254) 526-5389
Fax: (254) 526-4853
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 13560 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4672 Texas

Profile Details

NPI number 1376602110
LBN Legal business name Green, Daryl
Credentials LPC LMFT NCC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2006
Last updated Oct 21st, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376602110 NPPES
Texas Other 13560 LPC LICENSE NUMBER
Texas Other 4672 LPC LICENSE NUMBER
Texas MEDICAID 027164502 LPC LICENSE NUMBER

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