Healthcare Provider Details

I. General information

NPI: 1801572722
Provider Name (Legal Business Name): PROSPER HEALTH AND BEHAVIORAL CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 LORD BALTIMORE DR STE 301
WINDSOR MILL MD
21244-2653
US

IV. Provider business mailing address

13 DEVLON CT
OWINGS MILLS MD
21117-6124
US

V. Phone/Fax

Practice location:
  • Phone: 443-869-6490
  • Fax:
Mailing address:
  • Phone: 443-869-6490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIANA ADA NWAKAMMA
Title or Position: CEO
Credential:
Phone: 443-799-4247