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General NPI Number Information
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NPI Number | 1649099359
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Entity Type | Organization
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Legal Business Name | LOVE & CARE PSYCHIATRIST SERVICES LLC
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 850 STATLER BLVD. STE 120 #1031
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City | STAUNTON
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State | VA
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Zip | 24401
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Country | US
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Telephone | 240-203-4457
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Fax |
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Provider Business Mailing Address
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Address Line | 23 LOCUST HILL LN
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2247
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Country | US
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Telephone | 240-898-7692
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ADELINE TAKOH NGUM MANGWA
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Credential | PMHNP-BC
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Telephone | 917-979-8759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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