Healthcare Provider Details

I. General information

NPI: 1215742077
Provider Name (Legal Business Name): UZIMA CHILD & FAMILY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18310 MONTGOMERY VILLAGE AVE SUITE 410
GAITHERSBURG MD
20879
US

IV. Provider business mailing address

18310 MONTGOMERY VILLAGE AVE SUITE 410
GAITHERSBURG MD
20879
US

V. Phone/Fax

Practice location:
  • Phone: 301-358-3518
  • Fax:
Mailing address:
  • Phone: 301-358-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WILLIAMS
Title or Position: OWNER
Credential: LCPC
Phone: 301-358-3518