Dr. Cornelia Ellis Green
Counseling Psychologist
419 Pleasant St Suite 313
Beloit
, Wisconsin 53511-6249
Dr. Cornelia Ellis Green
Counseling Psychologist
419 Pleasant St Suite 313
Beloit
, Wisconsin 53511-6249
(608) 365-7464
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About
Features
Specialties
- Counseling Psychologist
Languages spoken
- English
Location
First Address
- Dr. Cornelia Ellis Green
- 419 Pleasant St Suite 313
- Beloit, WI
- Zip : 53511-6249
- Fax : (608) 365-7464
- Phone : (608) 365-7078
Second Address
- Dr. Cornelia Ellis Green
- 419 Pleasant St Suite 313
- Beloit, WI
- Zip : 53511-6249
- Fax : (608) 365-7464
- Phone : (608) 365-7078
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC1900X | Counseling Psychologist | 951-057 | WI |
National Provider Identifier
| NPI | 1023162468 |
|---|---|
| Provider Name | Dr. Cornelia Ellis Green |
| First Address | Beloit, WI 53511-6249 |
| Second Address | Beloit, WI 53511-6249 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 39027300 | (05) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.