Healthcare Provider Details

I. General information

NPI: 1518849553
Provider Name (Legal Business Name): OLIVER G NJONG LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 CEDAR LN
COLUMBIA MD
21044-2912
US

IV. Provider business mailing address

5755 CEDAR LN
COLUMBIA MD
21044-2912
US

V. Phone/Fax

Practice location:
  • Phone: 410-720-8713
  • Fax:
Mailing address:
  • Phone: 410-720-8713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21701
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: