Healthcare Provider Details

I. General information

NPI: 1558132910
Provider Name (Legal Business Name): EMERGE INTEGRATIVE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 FORBES BLVD STE 200-1076
LANHAM MD
20706-6312
US

IV. Provider business mailing address

4500 FORBES BLVD STE 200-1076
LANHAM MD
20706-6312
US

V. Phone/Fax

Practice location:
  • Phone: 240-776-5524
  • Fax:
Mailing address:
  • Phone: 240-776-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. HANSITTA UCHE ONYEMEZIKEYA
Title or Position: LCPC
Credential: LCPC
Phone: 240-776-5524