Provider Demographics
NPI:1770626285
Name:GREEN, ADELE C (PHD)
Entity type:Individual
Prefix:DR
First Name:ADELE
Middle Name:C
Last Name:GREEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 WESTOVER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-5555
Mailing Address - Country:US
Mailing Address - Phone:202-686-1263
Mailing Address - Fax:202-686-7096
Practice Address - Street 1:8720 GEORGIA AVENUE SUITE 300
Practice Address - Street 2:WILLIAM STIXRUD AND ASSOCIATES
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-565-0534
Practice Address - Fax:301-565-2217
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03086103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist