Individual provider Active NPI

Henrietta Sagoe, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Germantown, MD
National Provider Identifier
1003533415
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R182948 Issued in MD
Practice address
12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282
Phone
(301) 515-2901
NPI assigned
Oct 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R182948 MD Primary

Addresses

Primary practice location

12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282

Mailing address

13017 Wisteria Dr Ste 114
Germantown, MD 20874-2621
Phone (301) 812-4540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R182948MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Psychiatric and Mental Health Services LLC Psychiatric/Mental Health CurrentSince Nov 26, 2023 Accepting new patients

Locations

12800 Middlebrook Rd
Ste 400
Germantown, MD 20874
Phone (240) 217-7794

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1003533415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13017 WISTERIA DR STE 114",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742621",
            "telephone_number": "301-812-4540",
            "fax_number": "301-238-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MIDDLEBROOK RD STE 400",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745282",
            "telephone_number": "301-515-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGOE",
        "first_name": "HENRIETTA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R182948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.