Provider Demographics
NPI:1477113827
Name:GREENWOOD, NARDIA (LGPC,NCC)
Entity Type:Individual
Prefix:
First Name:NARDIA
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:LGPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MCMECHEN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-5351
Mailing Address - Country:US
Mailing Address - Phone:516-491-3081
Mailing Address - Fax:
Practice Address - Street 1:1930 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7006
Practice Address - Country:US
Practice Address - Phone:202-918-9657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC200001275101YM0800X, 101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator