MEDICARE: AMAKA AGULUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	95328	TX
2	101YM0800X	Mental Health Counselor	01252001	NY

General Provider Information

NPI Number	:	1235757139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAKA AGULUE

Provider Business Mailing Address
First Line	:	2213 RIDGMAR BLVD APT 1123
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-2306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2213 RIDGMAR BLVD APT 1123
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-2306
Country	:	US
Telephone Number	:	212-633-9300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2020
Last Update Date	:	12/15/2025

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Directions to “ AMAKA AGULUE ” Practice Location

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