Healthcare Provider Details

I. General information

NPI: 1689587909
Provider Name (Legal Business Name): OJORE SOLOMON AKWUE LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6311 AMES AVE STE 1048
OMAHA NE
68104-2027
US

IV. Provider business mailing address

930 FORT SILL BLVD
LAWTON OK
73503-4510
US

V. Phone/Fax

Practice location:
  • Phone: 410-419-7612
  • Fax:
Mailing address:
  • Phone: 410-419-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17432
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: