Healthcare Provider Details

I. General information

NPI: 1497567606
Provider Name (Legal Business Name): KINGSLEY OGBUJI LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 SAINT BERNARD AVE
NEW ORLEANS LA
70116-1319
US

IV. Provider business mailing address

2022 SAINT BERNARD AVE
NEW ORLEANS LA
70116-1319
US

V. Phone/Fax

Practice location:
  • Phone: 202-644-1912
  • Fax:
Mailing address:
  • Phone: 202-644-1912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9303
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: