Healthcare Provider Details
I. General information
NPI: 1588586531
Provider Name (Legal Business Name): MAGESTIC HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1629 K ST NW
WASHINGTON DC
20006-1602
US
IV. Provider business mailing address
1629 K ST NW
WASHINGTON DC
20006-1602
US
V. Phone/Fax
- Phone: 240-480-8280
- Fax:
- Phone: 240-480-8280
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CHRISTINE
A
NKWAIN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 240-480-8280