Healthcare Provider Details

I. General information

NPI: 1841108685
Provider Name (Legal Business Name): SWEETTEEN NGUGI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 W PRATT ST
BALTIMORE MD
21223-2251
US

IV. Provider business mailing address

10500 GRAND CENTRAL AVE
OWINGS MILLS MD
21117-4260
US

V. Phone/Fax

Practice location:
  • Phone: 443-449-6919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: