Divine Mental Health Services
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Washington, DC
NPI 1366022659 · NPPES record last updated Sep 17, 2021
Key facts
- NPI
- 1366022659
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- DIVINE MENTAL HEALTH SERVICES
- Practice address
- 7406 9TH St NW
Washington, DC 20012-1702 - Phone
- (301) 996-1230
- NPI assigned
- Apr 11, 2021
- Organization subpart
- No
Authorized official
- Name
- Agatha Nwangwu, NP
- Title
- Founder
- Phone
- (301) 996-1230
Practitioners 1
-
Agatha Ifeyinwa Nwangwu, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210913000570 | DC | Part B Supplier - Clinic/Group Practice | 7517363880 |
Receives reassigned benefits from 1 practitioner Practice locations: Washington, DC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
7406 9TH St NW
Washington, DC 20012-1702
Mailing address
7406 9TH St NW
Washington, DC 20012-1702
Other practice location 1
8955 Edmonston Rd Ste D
Greenbelt, MD 20770-4043
Phone (301) 996-1230
Other providers in Washington, DC
- Divine Connect Care Inc
- Divine Favour Health and Wellness
- Divine Health Care Inc
- Divine Healthcare Services,Inc
- Divine Hope Residential Care
- Divine Oracle Community Health Inc.
- Divine Providence Health Services
- Divine Touch Health Services, Inc.
- Ronak Dixit
- Ronald Eugene Dixo III
All providers in Washington, DC · Psychiatric/Mental Health Nurse Practitioner in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.