Icon Clinic LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ICON CLINIC LLC

Practice address

7735 Belle Point Dr
Greenbelt, MD 20770-3300

Phone

(240) 455-3166

Fax

(240) 455-4154

NPI assigned

Aug 22, 2022

Organization subpart

No

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

Authorized official

Name

Thickness Patrick EgwuatuNPI 1053997122

Title

Owner of Entity

Phone

(202) 288-7752

Specialties & licenses 1

Addresses

Tax ID family

Icon Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Icon Clinic LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenbelt, MD
  • NPI 1245808666
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thickness Patrick Egwuatu

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
  • NPI 1053997122
  NPD Authorized official

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1659090934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7735 BELLE POINT DR",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703300",
            "telephone_number": "240-455-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7735 BELLE POINT DR",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703300",
            "telephone_number": "240-455-3166",
            "fax_number": "240-455-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICON CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "EGWUATU",
        "authorized_official_first_name": "THICKNESS",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "202-288-7752"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ib Dental Iiii PC
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• Anthony I. Ibe, M.D.
• Ibrahima Physical Therapy Inc
• Icon Clinic LLC
• Sandra Iffa Itoh
• Abiodun Igandan, PHARM.D
• Regina Ejura Ijaja, NP
• Funke Ikoghode,
• Oluwatoyin Yewande Ikujuni, PHARMD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Greenbelt, MD
• Providers in Greenbelt, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.