Provider Demographics
NPI:1528435948
Name:GREEN, ALCHEMY (LCSW)
Entity type:Individual
Prefix:
First Name:ALCHEMY
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:247 CARDIFF WAY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-8305
Mailing Address - Country:US
Mailing Address - Phone:302-397-1955
Mailing Address - Fax:302-861-0647
Practice Address - Street 1:260 CHAPMAN RD STE 205A
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5449
Practice Address - Country:US
Practice Address - Phone:302-397-1955
Practice Address - Fax:302-861-0647
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
DEQ1-00119931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker