Abdul Malik Fofanah, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R215797 Issued in MD

Practice address

2115 N Charles St
Baltimore, MD 21218-5760

Phone

(240) 441-7536

Fax

(443) 449-5651

NPI assigned

Nov 22, 2022

Last updated

Jul 22, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Esowoh Healthcare

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, MD
  • NPI 1528826690
  Medicare reassignment NPD
• Resonance Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1821765926

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Esowoh Healthcare

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1720884869
  NPD (past) Authorized official
• Esowoh Healthcare

  • Adolescent and Children Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1750187043
  NPD (past) Authorized official

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1548979107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185760",
            "telephone_number": "240-441-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185760",
            "telephone_number": "240-441-7536",
            "fax_number": "443-449-5651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Martin Luther King Jr Ave SE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200321542",
            "country_code": "US",
            "telephone_number": "202-724-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOFANAH",
        "first_name": "ABDUL",
        "middle_name": "MALIK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R215797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Focuswell Mental Health Services
• Zachariah Foda, M.D., PH.D
• Lane Preston Fodel, CRNP
• Alexis Nicole Foehrkolb, OTD, OTR/L
• Massandje Bakayoko Fofana, PMHNP
• Jaminatu Fofanah
• Emiline Chandler Fogarty, APRN
• Sara Fogarty, D.O.
• Douglas Lloyd Fogel, PSY.D.
• Jessa Dean Fogel, MD

• Psychiatric/Mental Health Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, 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 Jul 22, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.