Healthcare Provider Details

I. General information

NPI: 1801242052
Provider Name (Legal Business Name): ORLENE JANICE GREEN L.A.D.C., LPC., M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 03/02/2025
Certification Date: 03/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 ALBANY AVE STE 301A
HARTFORD CT
06112-2132
US

IV. Provider business mailing address

1229 ALBANY AVE STE 301A
HARTFORD CT
06112-2132
US

V. Phone/Fax

Practice location:
  • Phone: 860-339-9614
  • Fax: 860-301-2467
Mailing address:
  • Phone: 860-339-9614
  • Fax: 860-232-0179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number001173
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number003342
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: