Provider Demographics
NPI:1194243147
Name:ESSIEN, DAVID IFIOKABASI (PSYD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:IFIOKABASI
Last Name:ESSIEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TYLER FALLS CT APT A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-5218
Mailing Address - Country:US
Mailing Address - Phone:914-819-2987
Mailing Address - Fax:
Practice Address - Street 1:1122 KENILWORTH DR STE 416
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2148
Practice Address - Country:US
Practice Address - Phone:443-451-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05855103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist