Essence Behavioral Health Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ESSENCE BEHAVIORAL HEALTH SERVICES LLC

Practice address

2700 Neabsco Common PL Ste 101
Woodbridge, VA 22191-6767

Phone

(984) 221-9288

NPI assigned

May 24, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Ellen Koduah-Agbo, DNP, APRN, PMNP-BCNPI 1306416672

Title

Ceo

Phone

(984) 221-9288

Specialties & licenses 1

Addresses

Other names 1

• ESSENCE BEHAVIORAL HEALTH SERVICES LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

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

• Ellen Koduah-Agbo, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, VA
  • NPI 1306416672

  Single Specialty

  Medicare reassignment NPD Authorized official
• Jodi Latoya Herndon, LPC, LSATP, CSAC

  • Professional Counselor
  • Charlottesville, VA
  • NPI 1447862933

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1740928209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NEABSCO COMMON PL STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916767",
            "telephone_number": "984-221-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NEABSCO COMMON PL STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916767",
            "telephone_number": "984-221-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENCE BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "KODUAH-AGBO",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "984-221-9288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, PMNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "doximity",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2700 Neabsco Common Pl Ste 101",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221916767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ESSENCE BEHAVIORAL HEALTH SERVICES LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon Grace Ervin
• Francisco T Escario, M.D.
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• Nahal Esmaeili, D.C.
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• Lauren Elizabeth Ethridge, RN
• Emmanuel Oghenekaro Etuke Jr., LCPC
• Evana Health Services

• Psychiatric/Mental Health Nurse Practitioner in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.