Healthcare Provider Details

I. General information

NPI: 1376386169
Provider Name (Legal Business Name): JOY OF LIFE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 BELAIR RD
BALTIMORE MD
21206-5665
US

IV. Provider business mailing address

4900 BELAIR RD
BALTIMORE MD
21206-5665
US

V. Phone/Fax

Practice location:
  • Phone: 443-790-5161
  • Fax:
Mailing address:
  • Phone: 443-790-5161
  • Fax: 410-261-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MERCY NWANKAMA
Title or Position: CLINICAL DIRECTOR
Credential: CRNP
Phone: 443-790-5161