Healthcare Provider Details

I. General information

NPI: 1528977634
Provider Name (Legal Business Name): ERIKA LASHAWN GREENE ADT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26845 POINT LOOKOUT RD
LEONARDTOWN MD
20650-4935
US

IV. Provider business mailing address

21155 LEXWOOD DR
LEXINGTON PARK MD
20653-4385
US

V. Phone/Fax

Practice location:
  • Phone: 240-309-4015
  • Fax: 240-309-4015
Mailing address:
  • Phone: 301-481-2632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: