Healthcare Provider Details

I. General information

NPI: 1700769916
Provider Name (Legal Business Name): LEAH ENGEL-GREEN PSY.D., NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HUNGERFORD DR
ROCKVILLE MD
20850-1718
US

IV. Provider business mailing address

17617 BUEHLER RD
OLNEY MD
20832-2329
US

V. Phone/Fax

Practice location:
  • Phone: 240-740-3250
  • Fax:
Mailing address:
  • Phone: 516-456-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number07605
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberCER-65875-B6B1J4
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: