Healthcare Provider Details

I. General information

NPI: 1992590657
Provider Name (Legal Business Name): HANNAH GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date: 04/21/2025
Reactivation Date: 06/11/2026

III. Provider practice location address

1367 GOVERNMENT RD
WILLIAMSBURG VA
23185-5771
US

IV. Provider business mailing address

1367 GOVERNMENT RD
WILLIAMSBURG VA
23185-5771
US

V. Phone/Fax

Practice location:
  • Phone: 804-832-5413
  • Fax:
Mailing address:
  • Phone: 804-832-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0903004271
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: