MEDICARE: GOSHEN WELLNESS AND BEHAVIORAL HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1730048216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOSHEN WELLNESS AND BEHAVIORAL HEALTHCARE

Provider Business Mailing Address
First Line	:	630 BENTGRASS DR
Second Line	:
City	:	ABERDEEN
State	:	MD
Zip	:	21001-3932
Country	:	US
Telephone Number	:	443-814-1230
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 BENTGRASS DR
Second Line	:
City	:	ABERDEEN
State	:	MD
Zip	:	21001-3932
Country	:	US
Telephone Number	:	443-814-1230
Fax Number	:

Authorized Official
Title or Position	:	OWNER OF ENTITY
Name	:	ELIZABETH OKUWA
Credential	:	DNP
Telephone Number	:	443-814-1230

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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