Individual provider Active NPI

Chinyere Evangeline Ubah, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Berlin, NJ
National Provider Identifier
1770907784
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00489500 Issued in NJ
Practice address
100 Townsend Ave
Berlin, NJ 08009-9011
Phone
(609) 534-9196
NPI assigned
Feb 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00489500 NJ Primary
Family Nurse Practitioner 363LF0000X 26NJ00489500 NJ

Addresses

Primary practice location

100 Townsend Ave
Berlin, NJ 08009-9011

Mailing address

100 Townsend Ave
Berlin, NJ 08009-9011
Phone (609) 248-0155

Other practice location 1

309 Fellowship Rd
Mount Laurel, NJ 08054-1234
Phone (609) 248-0155

Other names 1

  • Ms. Chinyere Evangeline Ohaegbulem Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180509000977 NJ Practitioner - Nurse Practitioner 5991069460 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Treatment Services IncGroup PAC ID 0042526899, 15 clinicians

Practice addresses (Care Compare)

795 Woodlane Rd
Westampton, NJ 08060-3832
Phone (609) 288-3067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00489500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Treatment Services Inc Current Accepting new patients
Legacy Treatment Services Inc CurrentSince Jun 22, 2022 Accepting new patients
Grow Healthcare Group of New Jersey PC Psychiatric/Mental Health CurrentSince Nov 13, 2024 Accepting new patients
Legacy Treatment Serivces, Inc. CurrentSince Jun 22, 2022 Accepting new patients
Krise Health Services LLC Current Accepting new patients
Krise Health Services LLC CurrentSince Apr 12, 2022 Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

519 Lakehurst Rd
Ste G
Browns Mills, NJ 08015
Phone (609) 248-5161

4 Haddonfield Rd
Ste 222
Cherry Hill, NJ 08002
Phone (215) 313-1989

1289 Route 38
Ste 203
Hainesport, NJ 08036
Phone (609) 267-1377

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

68 Culver Rd
Monmouth Junction, NJ 08852
Phone (609) 265-1895

309 Fellowship Rd
Ste 200
Mount Laurel, NJ 08054
Phone (267) 408-6770

10 Route 31 N
Ste 100
Pennington, NJ 08534

795 Woodlane Rd
Westampton, NJ 08060
Phone (609) 265-5800

795 Woodlane Rd
Ste 301
Westampton, NJ 08060
Phone (609) 267-1377

Organizations & group practices 7

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": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1770907784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TOWNSEND AVE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099011",
            "telephone_number": "609-248-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TOWNSEND AVE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099011",
            "telephone_number": "609-534-9196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Fellowship Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080541234",
            "country_code": "US",
            "telephone_number": "609-248-0155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UBAH",
        "first_name": "CHINYERE",
        "middle_name": "EVANGELINE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00489500",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00489500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHINYERE",
            "last_name": "OHAEGBULEM",
            "middle_name": "EVANGELINE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berlin, NJ

Sources for this page

Verify at the official NPI Registry.