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Leilani Lani Greening

Psychologist

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Leilani Lani Greening does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1477579167
Provider Type
Individual
Full Name
Greening, Leilani Lani
Title
Ms.
Credential
PHD

Gender
Female
Sole Proprietor
No
Enumeration Date
7/14/2006
Last Updated
9/21/2012

Contact Information

Practice Location

2500 N State St, Jackson, MS 39216-4500

(601) 984-5808

(601) 815-4710

Mailing Location

2500 N State St, Jackson, MS 39216-4500

(601) 984-5808

(601) 815-4710

Provider Taxonomies

Code	Description	License
Code 103TC0700X Primary	Description Psychologist Behavioral Health & Social Service Providers	License 46747 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 03132221	Description Medicaid	Issuer Unlisted Mississippi
ID 302I623569	Description Other	Issuer PTAN Mississippi

Leilani Lani Greening

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Logan, Patricia

Johnson, Cheryl Ann

Lakeland Drive Counseling, Llc

Patel, Amee B

Brown, Mary Evelyn

Taravella, Cicely C.

Young, Lashun A.

Gabriele, Jeanne Marisa

Stouter, Josephine H.

Foster, Penni Smith