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 EnrollmentThis provider is enrolled in PECOS as JENISE GREENE.Based on the most recent information from CMS, provider Jenise Tehvon Greene is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 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