Healthcare Provider Details

I. General information

NPI: 1417874975
Provider Name (Legal Business Name): NEW LIGHT MENTAL AND WELLNESS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 NIAGARA RD STE 408
COLLEGE PARK MD
20740-1160
US

IV. Provider business mailing address

4920 NIAGARA RD STE 408
COLLEGE PARK MD
20740-1160
US

V. Phone/Fax

Practice location:
  • Phone: 301-254-2095
  • Fax:
Mailing address:
  • Phone: 301-254-2095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MORAFA
Title or Position: NP
Credential: NP
Phone: 301-254-2095