=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528588456
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONIKE DARGBE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1007 LONGVIEW LN
-----------------------------------------------------
City | CULPEPER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22701-2989
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-317-7122
-----------------------------------------------------
Fax | 404-317-7122
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1007 LONGVIEW LN
-----------------------------------------------------
City | CULPEPER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22701-2989
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-317-7122
-----------------------------------------------------
Fax | 404-317-7122
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ONIKE M DARGBE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-317-7122
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 171W00000X
-----------------------------------------------------
Taxonomy Name | Contractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 172V00000X
-----------------------------------------------------
Taxonomy Name | Community Health Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------