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Organization

DR LUDY GREEN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH SHANE GREEN MPH (PARTNER)
(202) 769-7742
Entity
Organization

Contact information

Practice address
4968 QUEBEC ST NW, WASHINGTON, DC 20016-3231
(202) 769-7742
Mailing address
4968 QUEBEC ST NW, WASHINGTON, DC 20016-3231
(202) 769-7742

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
09/25/2025
Last updated
09/25/2025
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