Provider Demographics
NPI:1962412320
Name:FEVRY, NADEGE NICOLE
Entity type:Individual
Prefix:MRS
First Name:NADEGE
Middle Name:NICOLE
Last Name:FEVRY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:RAMA
Other - Middle Name:
Other - Last Name:PRAYAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6475 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 610
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3269
Mailing Address - Country:US
Mailing Address - Phone:301-270-3200
Mailing Address - Fax:301-270-4600
Practice Address - Street 1:6475 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3269
Practice Address - Country:US
Practice Address - Phone:301-270-3200
Practice Address - Fax:301-270-4600
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG57867Medicare UPIN