Provider Demographics
NPI:1558196642
Name:ONYEKWERE, ONYEKACHI
Entity type:Individual
Prefix:
First Name:ONYEKACHI
Middle Name:
Last Name:ONYEKWERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 BELAIR RD APT 2
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1294
Mailing Address - Country:US
Mailing Address - Phone:410-241-2682
Mailing Address - Fax:
Practice Address - Street 1:325 ELLINGTON BOULEVARD
Practice Address - Street 2:PMB 509
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:443-485-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15559101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health