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General NPI Number Information
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NPI Number | 1215829072
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Entity Type | Organization
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Legal Business Name | GRACIOUS PSYCHIATRIC HEALTHCARE SERVICES
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 9334 CREEKVIEW DR
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City | LAUREL
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State | MD
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Zip | 20708-3205
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Country | US
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Telephone | 301-768-7140
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Fax |
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Provider Business Mailing Address
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Address Line | 9334 CREEKVIEW DR
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City | LAUREL
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State | MD
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Zip | 20708-3205
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Country | US
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Telephone | 301-768-7140
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Fax |
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Authorized Official
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Title or Position | DNP, PMHNP-BC
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Name | DR. GOLDMAY OGBENYALU ONUMA
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Credential | DNP
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Telephone | 301-768-7140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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