Healthcare Provider Details

I. General information

NPI: 1154681088
Provider Name (Legal Business Name): EVELYN NGWINI PSYCH/MENTAL HEALTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14460 OLD MILL RD STE 201
UPPER MARLBORO MD
20772-3092
US

IV. Provider business mailing address

10300 ACKERLY TER
LANHAM MD
20706-2353
US

V. Phone/Fax

Practice location:
  • Phone: 202-282-3004
  • Fax: 202-282-2057
Mailing address:
  • Phone: 301-549-9062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR235284
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: