Emmanuel Oghenekaro Etuke Jr, LCPC | |
2750 Killarney Dr Ste 100, Woodbridge, VA 22192-4124 | |
(202) 809-3928 | |
Not Available |
Full Name | Emmanuel Oghenekaro Etuke Jr |
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Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 2750 Killarney Dr Ste 100, Woodbridge, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114516093 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LC14862 (Maryland) | Secondary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | LC14862 (Maryland) | Primary |
Entity Name | Safe Harbor Behavioral Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316487879 PECOS PAC ID: 0345514675 Enrollment ID: O20170925002242 |
Mailing Address | Practice Location Address |
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Emmanuel Oghenekaro Etuke Jr, LCPC 2750 Killarney Dr Ste 100, Woodbridge, VA 22192-4124 Ph: (202) 809-3928 | Emmanuel Oghenekaro Etuke Jr, LCPC 2750 Killarney Dr Ste 100, Woodbridge, VA 22192-4124 Ph: (202) 809-3928 |
Addie Mae Brown, LPC, LMFT, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13000 Harbor Center Dr Ste 352, Woodbridge, VA 22192 Phone: 703-270-1017 | |
Elizabeth Sue Wyman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4899 Prince William Pkwy, Woodbridge, VA 22192 Phone: 833-510-4357 | |
Mr. Dekiegai Eleazer Reeves, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14786 Barksdale St, Woodbridge, VA 22193 Phone: 703-864-4561 | |
Caitlin Lisee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13000 Harbor Center Dr Ste 301, Woodbridge, VA 22192 Phone: 703-492-2994 | |
Mr. Michael Howard Borash, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1388 Old Bridge Rd, Woodbridge, VA 22192 Phone: 800-799-1212 Fax: 703-492-7768 | |
Ms. Megan Yvonne Hess, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1954 Opitz Blvd Ste 7, Woodbridge, VA 22191 Phone: 703-492-2924 | |
Teresa Ann George, MA,LPC,NCC Counselor Medicare: Medicare Enrolled Practice Location: 2501 Hunter Pl Ste 202, Woodbridge, VA 22192 Phone: 571-365-3172 |