Healthcare Provider Details

I. General information

NPI: 1619226982
Provider Name (Legal Business Name): EMILY FORKA LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2012
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9470 ANNAPOLIS RD STE 101
LANHAM MD
20706-4048
US

IV. Provider business mailing address

9470 ANNAPOLIS RD STE 101
LANHAM MD
20706-4048
US

V. Phone/Fax

Practice location:
  • Phone: 202-499-4300
  • Fax:
Mailing address:
  • Phone: 240-945-9694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP18457
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: