Healthcare Provider Details

I. General information

NPI: 1518893726
Provider Name (Legal Business Name): MICHEL KAHAK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16618 CYPRESS BAY LN
ASHTON MD
20861
US

IV. Provider business mailing address

16618 CYPRESS BAY LN
ASHTON MD
20861
US

V. Phone/Fax

Practice location:
  • Phone: 301-641-1514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: