Lonnelle Antonio Green I

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

29516 Canvasback Dr
Easton, MD 21601-7140

Phone

(410) 822-5007

Fax

(410) 822-5569

NPI assigned

Nov 6, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eastern Shore Psychological Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chestertown, MD
  • NPI 1356798979
  NPD (past)

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1144400359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 GODDARD PKWY",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011126",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29516 CANVASBACK DR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017140",
            "telephone_number": "410-822-5007",
            "fax_number": "410-822-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LONNELLE",
        "middle_name": "ANTONIO",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunny Rae Granger, CNM
• Gratitude Behavioral Health LLC
• Greater Baltimore Medical Center, Inc.
• Eric Daniel Green, D.O.
• Lisa Green, LCPC
• Richard R Greenbaum, PHD
• Greenbrook TMS Easton LLC
• Lisa R Greene, PHARMACIST
• Antoine Gregory
• Sean Gretz, OD

• Counselor in Easton, MD
• Providers in Easton, MD by specialty
• Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.