Healthcare Provider Details

I. General information

NPI: 1598470817
Provider Name (Legal Business Name): NEW DIRECTION HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 02/12/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 WOODY TERRACE
CLINTON MD
20735
US

IV. Provider business mailing address

6701 GLENHURST DR
GLENN DALE MD
20769-9476
US

V. Phone/Fax

Practice location:
  • Phone: 301-565-2250
  • Fax:
Mailing address:
  • Phone: 202-509-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: NKECHI NIKKI FRANCA UKWANDU
Title or Position: ADMINISTRATOR
Credential:
Phone: 202-509-7000