Provider Demographics
NPI:1013803451
Name:DIAMOND GREENE LLC
Entity type:Organization
Organization Name:DIAMOND GREENE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:443-827-3124
Mailing Address - Street 1:6225 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1544
Mailing Address - Country:US
Mailing Address - Phone:443-827-3124
Mailing Address - Fax:
Practice Address - Street 1:6225 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-1544
Practice Address - Country:US
Practice Address - Phone:443-827-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health