Organization
GREEN HOLISTIC RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWANA JOHNSON GREEN SCD (CHIEF EXECUTIVE OFFICER)
(504) 606-9316
Entity
Organization
Contact information
Practice address
4520 WICHERS DR STE 202, MARRERO, LA 70072-3135
(504) 606-9316
(504) 383-0937
Mailing address
4520 WICHERS DRIVE, SUITE 202, MARRERO, LA 70072
(504) 606-9316
(504) 383-0937
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174H00000X
Health Educator
—
—
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433-04-7938
—
LA
05
—
554-99-5381
—
LA
Enumeration date
03/15/2023
Last updated
04/02/2025
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