Individual provider Active NPI

Ikechukwu Nwakanma, THERAPIST

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1285501924
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29004 Issued in MD
Practice address
5535 Belleville Ave
Baltimore, MD 21207-6945
Phone
(443) 502-0825
NPI assigned
Oct 18, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 29004 MD Primary

Addresses

Primary practice location

5535 Belleville Ave
Baltimore, MD 21207-6945

Mailing address

5535 Belleville Ave
Baltimore, MD 21207-6945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223001805 MD Practitioner - Clinical Social Worker 3173018546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1900 E Northern Pkwy
Suite T5
Baltimore, MD 21239-2120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29004MDMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Havenroot Therapy and Wellness Clinical CurrentSince Dec 21, 2025 Accepting new patients
Transforming Lives Counseling and PRP Services, LLC CurrentSince Oct 22, 2025 Accepting new patients

Locations

1900 E Northern Pkwy
Ste T5
Baltimore, MD 21239
Phone (410) 645-1000

6701 Democracy Blvd
Ste 300
Bethesda, MD 20817
Phone (443) 351-4650

Organizations & group practices 3

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": "1760745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1285501924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 BELLEVILLE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 BELLEVILLE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076945",
            "telephone_number": "443-502-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAKANMA",
        "first_name": "IKECHUKWU",
        "credential": "THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-18",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "29004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.