Healthcare Provider Details

I. General information

NPI: 1407409477
Provider Name (Legal Business Name): K&I HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 02/22/2026
Certification Date: 02/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11637 TERRACE DR STE 201
WALDORF MD
20602-3708
US

IV. Provider business mailing address

11637 TERRACE DR STE 201
WALDORF MD
20602-3708
US

V. Phone/Fax

Practice location:
  • Phone: 240-419-3803
  • Fax: 240-419-2931
Mailing address:
  • Phone: 240-419-3803
  • Fax: 240-667-1712

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
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KELVINDA KAMARA
Title or Position: NURSE PRACTITIONER
Credential: CRNP
Phone: 240-419-3803