Individual ProviderJenise Tehvon GreeneCounselorBehavioral Health & Social Service ProvidersPractice Address1808 Over Lake Dr SE Ste D, Conyers, GA 30013-6608(678) 213-2194(404) 273-8504PECOS EnrollmentBased on the most recent information from CMS, provider Jenise Tehvon Greene does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1255042495Provider TypeIndividualFull NameGreene, Jenise TehvonGenderFemaleSole ProprietorYesEnumeration Date12/8/2022Last Updated2/16/2023Contact InformationPractice LocationPractice Address1808 Over Lake Dr SE Ste D, Conyers, GA 30013-6608Phone(678) 213-2194FaxUnlisted FaxMailing LocationMailing Address1808 Over Lake Dr SE Ste D, Conyers, GA 30013-6608Phone(404) 273-8504FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLPC013548Georgia