Aquanda Green, LCAS, LCMHC
Counselor, Addiction (Substance Use Disorder) in Durham, NC. Individual provider (NPI-1).
NPI number1982162012
StatusActive
Last updated in NPPESAug 21, 2024
Details
- NPI
- 1982162012
- Entity type
- Individual (NPI-1)
- Name
- Aquanda Green
- Credential
- LCAS, LCMHC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 7, 2019
- Certification date
- Aug 21, 2024
- Last updated
- Aug 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 24361 | NC | Yes |
| 101YM0800X | Counselor, Mental Health | 17294 | NC |
Practice location
249 E Nc Highway 54 Ste 320Durham, NC 27713-2490
Phone 919-402-6939
Mailing address
115 Woodtrellis CtDurham, NC 27703-9612
Phone 919-402-6939
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