Male or Other

Mr. Wade M. Green MA, NCC, LCPC

Mental Health Counselor in La Plata, MD(View on Map)

Full Name

Mr. Wade M Green MA, NCC, LCPC

NPI Number

1033221676

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/31/2006

Specialties

(Taxonomies)

Code

101YM0800X

Primary Taxonomy

Yes

Licenses

State

Maryland

License Number

LC2196

Contact
Information

Purpose

Mailing
Location

Address

4665 PRESTANCIA PL APT 303
6100 RADIO STATION RD.

City

Waldorf
La Plata

State

MD
MD

Postal Code

20602-4131
20646

Country

US
US

Telephone Number

(301) 928-6045
(301) 609-9887

Identifiers

Identifier

521450501
521450500

Identifier State

MD
MD

Identifier Issuer

Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/02/2009

Provider Address

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