Healthcare Provider Details

I. General information

NPI: 1528435948
Provider Name (Legal Business Name): ALCHEMY GREEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: N/A N/A N/A N/A

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 RICKEY BLVD UNIT 246
BEAR DE
19701-8610
US

IV. Provider business mailing address

125 RICKEY BLVD UNIT 246
BEAR DE
19701-8610
US

V. Phone/Fax

Practice location:
  • Phone: 302-397-1955
  • Fax: 302-861-0647
Mailing address:
  • Phone: 302-397-1955
  • Fax: 302-861-0647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0011993
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: