Healthcare Provider Details

I. General information

NPI: 1417878836
Provider Name (Legal Business Name): CORDIAL HEALTH CARE CONSORTIUM OF PROVIDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9821 GREENBELT RD STE 207
LANHAM MD
20706-2269
US

IV. Provider business mailing address

9821 GREENBELT RD STE 207
LANHAM MD
20706-2269
US

V. Phone/Fax

Practice location:
  • Phone: 301-220-3500
  • Fax: 301-982-0321
Mailing address:
  • Phone: 301-220-3500
  • Fax: 301-982-0321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE JAMES-OSONDU
Title or Position: OWNER
Credential:
Phone: 972-408-5883