MEDICARE: DR. GODWIN OGHENENYERHOVWO OSHEGBO LCPC

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	LC4157	MD
2	101YP2500X	Professional Counselor	LC4157	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LC4157	OTHER	MD	STATE BOARD
2	99-2613231	OTHER		IRS

General Provider Information

NPI Number	:	1922339894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GODWIN OGHENENYERHOVWO OSHEGBO LCPC

Provider Business Mailing Address
First Line	:	3514 STONEY CREEK CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-1522
Country	:	US
Telephone Number	:	443-430-1726
Fax Number	:	443-200-1514

Provider Business Practice Location Address
First Line	:	3514 STONEY CREEK CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-1522
Country	:	US
Telephone Number	:	443-430-1726
Fax Number	:	443-200-1514

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

Provider Enumeration Date	:	01/16/2010
Last Update Date	:	06/25/2026

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