Individual provider Active NPI

Lucy Kelechi Ukachukwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Colonial Heights, VA
National Provider Identifier
1407677370
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024191557 Issued in VA
Practice address
3611 Boulevard
Colonial Heights, VA 23834
Phone
(804) 391-0659
Fax
(804) 207-8884
NPI assigned
Oct 22, 2024
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 0024191557 VA Primary

Addresses

Primary practice location

3611 Boulevard
Colonial Heights, VA 23834

Mailing address

3611 Boulevard
Colonial Heights, VA 23834-1344
Phone (701) 989-2057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260210001379 VA Practitioner - Nurse Practitioner 8921587999 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3611 Boulevard
Colonial Heights, VA 23834-1344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024191557VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Restora Psychiatry LLC Psychiatric/Mental Health CurrentSince Nov 24, 2025 Accepting new patients

Locations

3611 Boulevard
Colonial Hgts, VA 23834
Phone (804) 526-2816

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1407677370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341344",
            "telephone_number": "701-989-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "23834",
            "telephone_number": "804-391-0659",
            "fax_number": "804-207-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKACHUKWU",
        "first_name": "LUCY",
        "middle_name": "KELECHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024191557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.