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General NPI Number Information
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NPI Number | 1083193114
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Entity Type | Individual
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Provider Name | AKAMIN VICTOR NKENGAKA PH.D., LCSW, LMSW
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Gender | Male
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 5410 MARYLAND WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-5064
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Country | US
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Telephone | 855-212-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 2337 LAURELWOOD DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-3045
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Country | US
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Telephone | 318-294-8877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCI12800718
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10551
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | Q0000185
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | G0088
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW03186
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License Number State | RI
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