Healthcare Provider Details

I. General information

NPI: 1649099359
Provider Name (Legal Business Name): LOVE & CARE PSYCHIATRIST SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 RESERVOIR ST STE 203
HARRISONBURG VA
22801-8722
US

IV. Provider business mailing address

2015 RESERVOIR ST STE 203
HARRISONBURG VA
22801-8722
US

V. Phone/Fax

Practice location:
  • Phone: 240-203-4457
  • Fax:
Mailing address:
  • Phone: 240-898-7692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ADELINE TAKOH NGUM MANGWA
Title or Position: OWNER/PROVIDER
Credential: PMHNP-BC
Phone: 917-979-8759