Ukoh Metro Mental Healthcare, PA

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AC 001241 Issued in MD

Legal business name

UKOH METRO MENTAL HEALTHCARE, PA

Practice address

4404 Queensbury Rd
Riverdale Park, MD 20737-1068

Phone

(240) 467-2116

Fax

(240) 764-7527

NPI assigned

Apr 7, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Immaculata Ukoh, NURSE PRACTITIONER

Title

President/Ceo

Phone

(240) 467-2116

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Immaculata Ulu, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverdale Park, MD
  • NPI 1740298579
  NPD (past)

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1831518802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD",
            "city": "RIVERDALE PARK",
            "state": "MD",
            "postal_code": "207371068",
            "telephone_number": "240-467-2116",
            "fax_number": "240-764-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD",
            "city": "RIVERDALE PARK",
            "state": "MD",
            "postal_code": "207371068",
            "telephone_number": "240-467-2116",
            "fax_number": "240-764-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UKOH METRO MENTAL HEALTHCARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "UKOH",
        "authorized_official_first_name": "IMMACULATA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "240-467-2116",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC 001241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dentistry of Maryland, LLC
• Physical Therapy and Pain Management Center LLC
• Prime Health and Wellness LLC
• Douglas Lee Sims Jr., D.C.
• Smileworks Dental & Orthodontics, LLC
• Immaculata Ulu, CRNP
• Mary Theresa Wheatley

• Psychiatric/Mental Health Nurse Practitioner in Riverdale Park, MD
• Providers in Riverdale Park, 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 Apr 7, 2014; 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.