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NPI Code Detail

MEDICARE: CHARLOTTE FOMENGIA LGPC

MEDICARE: CHARLOTTE FOMENGIA LGPC
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
1101YM0800XMental Health CounselorLGP16352MD

General Provider Information

NPI Number : 1871484428
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE FOMENGIA LGPC
Provider Business Mailing Address
First Line : 614 LAMBERTON DR
Second Line :
City : SILVER SPRING
State : MD
Zip : 20902-1628
Country : US
Telephone Number : 240-339-3731
Fax Number :
Provider Business Practice Location Address
First Line : 614 LAMBERTON DR
Second Line :
City : SILVER SPRING
State : MD
Zip : 20902-1628
Country : US
Telephone Number : 240-339-3731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2025
Last Update Date : 07/11/2025

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Directions to “ CHARLOTTE FOMENGIA LGPC” Practice Location

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