Healthcare Provider Details

I. General information

NPI: 1568375848
Provider Name (Legal Business Name): GREEN FEATHER THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 HILLSIDE RD
SAINT LEONARD MD
20685-2576
US

IV. Provider business mailing address

6050 HILLSIDE RD
SAINT LEONARD MD
20685-2576
US

V. Phone/Fax

Practice location:
  • Phone: 240-466-1003
  • Fax:
Mailing address:
  • Phone: 240-466-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. AMANDA MARIE LEAL
Title or Position: OWNER/THERAPIST
Credential: LCSW-C
Phone: 240-466-1003