Wade M Green Jr., MA, NCC, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC2196 Issued in MD

Practice address

6100 Radio Station Rd.
La Plata, MD 20646

Phone

(301) 609-9887

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1033221676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4665 PRESTANCIA PL APT 303",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206024131",
            "telephone_number": "301-928-6045",
            "fax_number": "301-392-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 RADIO STATION RD.",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "20646",
            "telephone_number": "301-609-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WADE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MA, NCC, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC2196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521450501",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521450500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Goulston, O.D.
• Holly Grant, CCC-SLP
• Triverr Gray, RN
• Greater Baden Medical Service Incorporated
• Twhanna Jones Green
• Haley Elizabeth Gregory, MS, ED CCC-SLP
• Marilyn Edwards Gregory, BSN, RNFA, CNOR
• James Gretton, PHARMD
• Cassandra Griffin-Weathers, CRNA
• Yuh-Jen Guo, LCPC

• Mental Health Counselor in La Plata, MD
• Providers in La Plata, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.