| Icon Clinic Llc | |
|
6128 Landover Rd Cheverly MD 20785-1016 | |
| (202) 288-7752 | |
| (303) 552-9381 |
| Full Name | Icon Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6128 Landover Rd, Cheverly, Maryland |
| Authorized Official Name and Position | Thickness Patrick Egwuatu (PROVIDER/CEO) |
| Authorized Official Contact | 2022887752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icon Clinic Llc 10604 Wood Pointe Ct Glenn Dale MD 20769-2112 Ph: (202) 288-7752 | Icon Clinic Llc 6128 Landover Rd Cheverly MD 20785-1016 Ph: (202) 288-7752 |
| NPI Number | 1245808666 |
|---|---|
| Provider Enumeration Date | 06/13/2021 |
| Last Update Date | 08/09/2021 |
| Certification Date | 08/09/2021 |
| Medicare PECOS PAC ID | 7719383967 |
|---|---|
| Medicare Enrollment ID | O20210914000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245808666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Thickness Patrick Egwuatu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053997122 PECOS PAC ID: 8628474871 Enrollment ID: I20210914000371 |
Allied Behavioral Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3001 Hospital Dr, Cheverly, MD 20785 Phone: 301-618-2000 | |
Prince George's County Health Department Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3003 Hospital Drive - Ground Floor, Cheverly, MD 20785 Phone: 301-583-5920 Fax: 301-583-5953 | |
Crawford Consulting And Mental Health Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6490 Landover Rd, Suite D, Cheverly, MD 20785 Phone: 301-341-5111 Fax: 301-341-5211 | |
Unique Homehealth Care Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6490 Landover Rd Ste E7, Cheverly, MD 20785 Phone: 240-486-5720 | |
Gambrills Sisters Health Care Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6490 Landover Rd, Cheverly, MD 20785 Phone: 240-437-2705 | |
Cdc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3003 Hospital Dr, Cheverly, MD 20785 Phone: 301-583-3750 Fax: 301-583-3794 |