Healthcare Provider Details

I. General information

NPI: 1053105304
Provider Name (Legal Business Name): CYNTHIA M NJATCHA NJATCHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 MOUNTAIN ASH CT
GREENSBORO NC
27410-9608
US

IV. Provider business mailing address

5101 MOUNTAIN ASH CT
GREENSBORO NC
27410-9608
US

V. Phone/Fax

Practice location:
  • Phone: 240-600-4408
  • Fax: 240-600-4408
Mailing address:
  • Phone: 240-600-4408
  • Fax: 240-600-4408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPO21438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: