Individual provider Active NPI

Cecilia Ntobo Faison Ngwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Ruther Glen, VA
National Provider Identifier
1619694361
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2022064027 Issued in VA
Practice address
5322 Ladysmith Rd
Ruther Glen, VA 22546-1325
Phone
(757) 535-9609
Fax
(571) 473-5954
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 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 2022064027 VA Primary

Addresses

Primary practice location

5322 Ladysmith Rd
Ruther Glen, VA 22546-1325

Mailing address

5322 Ladysmith Rd
Ruther Glen, VA 22546-1325
Phone (757) 535-9609

Other practice location 1

7338 Legacy Ln
Ruther Glen, VA 22546-2954
Phone (757) 535-9609

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
I20230315002613 VA Practitioner - Nurse Practitioner 6204205685 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
We Help Our AdolescentsGroup PAC ID 1850790957, 20 clinicians
Ascension Psychiatric Services LLCGroup PAC ID 0840723557, 6 clinicians

Practice addresses (Care Compare)

6010 W Broad St
Suite 103
Richmond, VA 23230-2215
Phone (804) 306-3219

903 W Broadway
Hopewell, VA 23860-2536
Phone (757) 373-1913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2022064027VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Mental Health LLC Psychiatric/Mental Health CurrentSince Oct 30, 2022 Accepting new patients
Rappahannock Area Community Services Board CurrentSince Jul 30, 2023 Accepting new patients
Supportive Care of Virginia LLC CurrentSince Feb 1, 2023 Accepting new patients
We Help Our Adolescents CurrentSince Jul 16, 2024 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

600 Jackson St
Fredericksburg, VA 22401
Phone (540) 373-3223

6010 W Broad St
Ste 103
Richmond, VA 23230
Phone (804) 282-1863

5322 Ladysmith Rd
Ruther Glen, VA 22546
Phone (757) 535-9609

19254 Rogers Clark Blvd
Ruther Glen, VA 22546
Phone (804) 633-9997

831 E Ellerslie Ave
South Chesterfield, VA 23834
Phone (718) 298-7345

Organizations & group practices 5

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1619694361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 LADYSMITH RD",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225461325",
            "telephone_number": "757-535-9609",
            "fax_number": "571-473-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5322 LADYSMITH RD",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225461325",
            "telephone_number": "757-535-9609",
            "fax_number": "571-473-5954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7338 Legacy Ln",
            "address_purpose": "LOCATION",
            "city": "Ruther Glen",
            "state": "VA",
            "postal_code": "225462954",
            "country_code": "US",
            "telephone_number": "757-535-9609",
            "fax_number": "571-473-5954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAISON NGWA",
        "first_name": "CECILIA",
        "middle_name": "NTOBO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "2022064027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruther Glen, VA

Sources for this page

Verify at the official NPI Registry.