Queendaline Nwobodo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R230325 Issued in MD

Practice address

1720 Sea Pine Cir
Severn, MD 21144-1017

Phone

(443) 345-7967

NPI assigned

Apr 17, 2020

Last updated

Jan 9, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Axis Behavioral Health LLCGroup PAC ID 6507396199, 2 clinicians

Hightower Behavioral HealthGroup PAC ID 5799114591, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Axis Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hanover, MD
  • NPI 1063226280
  Medicare reassignment Care Compare group NPD Authorized official
• Hightower Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1972140069
  Medicare reassignment Care Compare group NPD
• Resonance Behavioral Health Services

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

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Arising Behavioral Health and Services LLC

  • Psychiatry Physician
  • Washington, DC
  • NPI 1225735848
  Medicare reassignment NPD
• Elevate Health Solutions, LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1437974961

  Nurse Practitioner

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Human Charity Solutions

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
  • NPI 1255189213
  Medicare reassignment
• Elevate Health Solutions, LLC

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1003601006

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1750901955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 SEA PINE CIR",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SEA PINE CIR",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441017",
            "telephone_number": "443-345-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOBODO",
        "first_name": "QUEENDALINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "NP200003026",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R230325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan D Nevius, BS, LMT
• Newdesthomes LLC
• Mariama Njoya
• Nordic Hearts Therapy, LLC
• Chidimma Uche Nwabueze
• Noella Nzobella
• Colleen O'Neill, MS OTR/L
• Oluwaseun Odebunmi, PHARM. D.
• Adenike I Odubore
• Fausat Oluremi Ojo, DNP APRN AGPCNP-BC

• Psychiatric/Mental Health Nurse Practitioner in Severn, MD
• Providers in Severn, 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 Jan 9, 2025; 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.