Gladstreams Mental Health & Wellness ,llc | |
4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 | |
(202) 203-9567 | |
Not Available |
Full Name | Gladstreams Mental Health & Wellness ,llc |
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Speciality | Clinic/Center |
Location | 4500 Forbes Blvd Ste 200, Lanham, Maryland |
Authorized Official Name and Position | Olayinka Sogbola (NURSE PRACTITIONER) |
Authorized Official Contact | 2022039567 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gladstreams Mental Health & Wellness ,llc 4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 Ph: () - | Gladstreams Mental Health & Wellness ,llc 4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 Ph: (202) 203-9567 |
NPI Number | 1629850979 |
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Provider Enumeration Date | 10/19/2023 |
Last Update Date | 10/19/2023 |
Certification Date | 10/19/2023 |
Medicare PECOS PAC ID | 4385093533 |
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Medicare Enrollment ID | O20231213001040 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629850979 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Olayinka Sogbola |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467132027 PECOS PAC ID: 5294184446 Enrollment ID: I20231213001158 |
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