Provider Demographics
NPI:1306636873
Name:PENN-GREEN, ANDRIAN SHENICE
Entity type:Individual
Prefix:
First Name:ANDRIAN
Middle Name:SHENICE
Last Name:PENN-GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MORNING DOVE WAY
Mailing Address - Street 2:
Mailing Address - City:VINCENT
Mailing Address - State:AL
Mailing Address - Zip Code:35178-7780
Mailing Address - Country:US
Mailing Address - Phone:205-432-9453
Mailing Address - Fax:
Practice Address - Street 1:2201 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-4221
Practice Address - Country:US
Practice Address - Phone:205-277-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker