Healthcare Provider Details

I. General information

NPI: 1538063508
Provider Name (Legal Business Name): BANGAI MENTAL HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 GREENVIEW DR STE 454
LAUREL MD
20708-3287
US

IV. Provider business mailing address

7302 WELLBROOK CT, LAUREL
LAUREL MD
20707
US

V. Phone/Fax

Practice location:
  • Phone: 919-884-0813
  • Fax:
Mailing address:
  • Phone: 919-452-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ABIBATU BAKARR BANGAI
Title or Position: CEO
Credential:
Phone: 919-884-0813