Healthcare Provider Details

I. General information

NPI: 1649087669
Provider Name (Legal Business Name): NKAMEN HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9923 GOOD LUCK RD APT 101
LANHAM MD
20706-3255
US

IV. Provider business mailing address

9923 GOOD LUCK RD APT 101
LANHAM MD
20706-3255
US

V. Phone/Fax

Practice location:
  • Phone: 240-262-4918
  • Fax:
Mailing address:
  • Phone: 240-262-4918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE KEMGUE
Title or Position: MANAGER
Credential: SK
Phone: 240-505-4326