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General NPI Number Information
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NPI Number | 1205285202
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Entity Type | Organization
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Legal Business Name | ALEX GREEN & ASSOCIATES
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 2115 N CHARLES ST SUITE 200
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City | BALTIMORE
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State | MD
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Zip | 21218-5760
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Country | US
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Telephone | 410-808-2786
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 MERIDENE DR SUITE 509
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City | BALTIMORE
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State | MD
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Zip | 21239-2032
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Country | US
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Telephone | 410-808-2786
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ALEX GREEN
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Credential | LCPC
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Telephone | 410-808-2786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LC2308
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC2308
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License Number State | MD
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