Healthcare Provider Details

I. General information

NPI: 1194639948
Provider Name (Legal Business Name): ASPIRA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MERCANTILE LN STE 200T
UPPER MARLBORO MD
20774-4312
US

IV. Provider business mailing address

1401 MERCANTILE LN STE 200T
UPPER MARLBORO MD
20774-4312
US

V. Phone/Fax

Practice location:
  • Phone: 240-645-8864
  • Fax:
Mailing address:
  • Phone: 240-645-8864
  • Fax:

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 StateNULL

VIII. Authorized Official

Name: DR. RICHARD A. NKWETTA
Title or Position: CEO/DIRECTOR
Credential: DNP, MSN, PMHNP-BC
Phone: 240-645-8864