Healthcare Provider Details

I. General information

NPI: 1639900301
Provider Name (Legal Business Name): KES HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6480 NEW HAMPSHIRE AVE STE 301
TAKOMA PARK MD
20912-4716
US

IV. Provider business mailing address

6480 NEW HAMPSHIRE AVE STE 301
TAKOMA PARK MD
20912-4716
US

V. Phone/Fax

Practice location:
  • Phone: 215-594-9392
  • Fax:
Mailing address:
  • Phone: 240-978-5655
  • Fax: 276-248-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE EYEGUE-SANDY
Title or Position: PRESIDENT
Credential: DNP
Phone: 703-935-9442