Adeline T Mangwa, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R230111 Issued in MD

Practice address

10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648

Phone

(240) 203-4457

NPI assigned

May 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Shenandoah Psychiatric Medicine LLCGroup PAC ID 7012160716, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Love & Care Psychiatrist Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Harrisonburg, VA
  • NPI 1649099359
  Medicare reassignment NPD Authorized official
• Shenandoah Psychiatric Medicine LLC

  • Community Health Worker
  • Fishersville, VA
  • NPI 1659624054
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Lovingcare Mental Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hagerstown, MD
  • NPI 1013769058
  NPD Authorized official
• Love & Care Homehealth Care Services

  • Home Health Agency
  • Harrisonburg, VA
  • NPI 1306634795
  NPD Authorized official

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1497015283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12912 CONAMAR DR UNIT 1931",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217427505",
            "telephone_number": "240-898-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 LITTLE PATUXENT PKWY STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443648",
            "telephone_number": "240-203-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGWA",
        "first_name": "ADELINE",
        "middle_name": "T",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R230111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497015283",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Manchester
• Venkateswara Rao Mandava, M.D
• Julia Ballance Mandes, L.AC.
• Leon Mandler, PSY.D.
• Natalie Veronica Mangione
• Manisha Dhananjaya DDS LLC
• Allen M Manison, D.C.
• Maurine Mankah
• Danielle De Guzman Manlangit
• Bonnie Manley, RN

• Psychiatric/Mental Health Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.