| Clarksburg Behavioral Health Llc | |
|
23310 Frederick Rd Clarksburg MD 20871-9704 | |
| (240) 755-6285 | |
| Not Available |
| Full Name | Clarksburg Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 23310 Frederick Rd, Clarksburg, Maryland |
| Authorized Official Name and Position | Monica Manka Ngwa (PMHNP) |
| Authorized Official Contact | 2407556285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksburg Behavioral Health Llc 23310 Frederick Rd Clarksburg MD 20871-9704 Ph: (240) 755-6285 | Clarksburg Behavioral Health Llc 23310 Frederick Rd Clarksburg MD 20871-9704 Ph: (240) 755-6285 |
| NPI Number | 1194594317 |
|---|---|
| Provider Enumeration Date | 12/28/2023 |
| Last Update Date | 04/05/2024 |
| Certification Date | 04/05/2024 |
| Medicare PECOS PAC ID | 8123469004 |
|---|---|
| Medicare Enrollment ID | O20240509000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194594317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Monica M Ngwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912646738 PECOS PAC ID: 2163899907 Enrollment ID: I20221208000356 |
| Provider Name | Regina Afriyie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124776224 PECOS PAC ID: 6305287285 Enrollment ID: I20241206002073 |
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