Healthcare Provider Details

I. General information

NPI: 1437081049
Provider Name (Legal Business Name): CLARESSA NICOLE IWUKEMJIKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9522 FERN HOLLOW WAY
GAITHERSBURG MD
20886-1405
US

IV. Provider business mailing address

700 ROEDER RD UNIT 104
SILVER SPRING MD
20910-5180
US

V. Phone/Fax

Practice location:
  • Phone: 240-418-2622
  • Fax:
Mailing address:
  • Phone: 202-642-1821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: