Healthcare Provider Details

I. General information

NPI: 1619811007
Provider Name (Legal Business Name): BRIGHTWAY PROFESSIONALS AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 SAINT BARNABAS RD # 201
TEMPLE HILLS MD
20748-4604
US

IV. Provider business mailing address

4810 SAINT BARNABAS RD # 201
TEMPLE HILLS MD
20748-4604
US

V. Phone/Fax

Practice location:
  • Phone: 301-899-2200
  • Fax: 301-234-6308
Mailing address:
  • Phone: 301-899-2200
  • Fax: 301-234-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: BAYO AKINTIMEHIN
Title or Position: CEO
Credential:
Phone: 301-899-2200