Stacy Lynn Green

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

A02129 Issued in MD

Practice address

525 Glenburn Ave
Cambridge, MD 21613-1414

Phone

(410) 221-1400

NPI assigned

Jul 4, 2014

Last updated

Jul 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1404432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1558777094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5278 WHITE DEER RD",
            "city": "DELMAR",
            "state": "DE",
            "postal_code": "199403075",
            "telephone_number": "302-907-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 GLENBURN AVE",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131414",
            "telephone_number": "410-221-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-04",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A02129",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "DE",
            "license": "U2-0001489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Goddard Brant, PA-C
• Brittany Gowe, CRNP
• Gratitude Behavioral Health LLC
• Pamela Graves
• Latrice Kiane Gray, MSW, LCSW-C, RPT
• Katherine Griffin, NP
• Anna Zito Hackney
• Ashley Hall, MS, CAC-AD
• Vicki Ann Hardisty, APRN, CNP
• Sara H Hartman, LGSW

• Occupational Therapy Assistant in Cambridge, MD
• Providers in Cambridge, MD by specialty
• Occupational Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2014; 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.