Healthcare Provider Details

I. General information

NPI: 1215841267
Provider Name (Legal Business Name): MARCIA NAOMI GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NAOMI GREEN

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2488 MADISON RD
CINCINNATI OH
45208-1216
US

IV. Provider business mailing address

2488 MADISON RD
CINCINNATI OH
45208-1216
US

V. Phone/Fax

Practice location:
  • Phone: 513-220-2611
  • Fax:
Mailing address:
  • Phone: 513-220-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1802772
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: