MEDICARE: KEDU BEHAVIORAL HEALTH SERVICES LLC

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	:	1851224224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEDU BEHAVIORAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	12425 DIPLOMA DR
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-6040
Country	:	US
Telephone Number	:	410-207-8691
Fax Number	:

Provider Business Practice Location Address
First Line	:	2914 E JOPPA RD STE 204
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3045
Country	:	US
Telephone Number	:	410-207-8691
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	MRS. JULIET UGOCHI NWOKEDI
Credential	:	PMHNP-BC
Telephone Number	:	410-207-8691

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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