Provider Demographics
NPI:1386882819
Name:NWADIGO, OKECHUKWU C (MSW, ACSW, CADC II)
Entity type:Individual
Prefix:MR
First Name:OKECHUKWU
Middle Name:C
Last Name:NWADIGO
Suffix:
Gender:M
Credentials:MSW, ACSW, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 SAN LUCAS DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-7606
Mailing Address - Country:US
Mailing Address - Phone:925-698-0854
Mailing Address - Fax:925-291-2410
Practice Address - Street 1:1304 SAN LUCAS DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-7606
Practice Address - Country:US
Practice Address - Phone:925-698-0854
Practice Address - Fax:925-291-2410
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARA859209101YA0400X
CAASW 271031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARA859209OtherCERTIFICATION