Active NPI
Elizabeth Tallmadge Green
- Addiction (Substance Use Disorder) Psychologist
- Frederick, MD
National Provider Identifier
1144069261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Psychologist
- License
- LCA3221
- Practice address
- 103 E 2ND St Apt 2
Frederick, MD 21701-7200 - Phone
- (410) 777-0710
- NPI assigned
- May 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | LCA3221 | MD | Primary |
Addresses
Primary practice location
103 E 2ND St Apt 2
Frederick, MD 21701-7200
Mailing address
103 E 2ND St Apt 2
Frederick, MD 21701-7200
Phone (410) 777-0710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCA3221 | MD | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1144069261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 E 2ND ST APT 2",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217017200",
"telephone_number": "410-777-0710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 E 2ND ST APT 2",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217017200",
"telephone_number": "410-777-0710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ELIZABETH",
"middle_name": "TALLMADGE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "LCA3221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.