Healthcare Provider Details

I. General information

NPI: 1538533146
Provider Name (Legal Business Name): IHUOMA OHAMADIKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 RED TIP LN
ALBANY GA
31721-6358
US

IV. Provider business mailing address

198 S MACARTHUR DR
CAMILLA GA
31730-6370
US

V. Phone/Fax

Practice location:
  • Phone: 908-294-8461
  • Fax:
Mailing address:
  • Phone: 229-336-2247
  • Fax: 229-336-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009696
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: