| Destiny Psychiatry Care Llc | |
|
4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 | |
| (301) 778-6739 | |
| Not Available |
| Full Name | Destiny Psychiatry Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4500 Forbes Blvd Ste 200, Lanham, Maryland |
| Authorized Official Name and Position | Yvonne Mba (PROVIDER) |
| Authorized Official Contact | 3017786739 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Psychiatry Care Llc 4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 Ph: (301) 778-6739 | Destiny Psychiatry Care Llc 4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 Ph: (301) 778-6739 |
| NPI Number | 1750156923 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Medicare PECOS PAC ID | 2860835410 |
|---|---|
| Medicare Enrollment ID | O20240210000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750156923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Yvonne Abonge Mba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629641121 PECOS PAC ID: 1759770076 Enrollment ID: I20240210000019 |
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