Healthcare Provider Details

I. General information

NPI: 1922945880
Provider Name (Legal Business Name): FELIX KEMGOU KEBING
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13617 GRESHAM CT
BOWIE MD
20720-5316
US

IV. Provider business mailing address

13617 GRESHAM CT
BOWIE MD
20720-5316
US

V. Phone/Fax

Practice location:
  • Phone: 240-486-4034
  • Fax:
Mailing address:
  • Phone: 240-486-4034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: