| Petals Behavioral Llc | |
|
12623 Epping Rd Silver Spring MD 20906-3865 | |
| (617) 777-0764 | |
| Not Available |
| Full Name | Petals Behavioral Llc |
|---|---|
| Speciality | Social Worker |
| Location | 12623 Epping Rd, Silver Spring, Maryland |
| Authorized Official Name and Position | Chekwube Nwabueze (MANAGING PARTNER) |
| Authorized Official Contact | 4125966493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petals Behavioral Llc 12623 Epping Rd Silver Spring MD 20906-3865 Ph: () - | Petals Behavioral Llc 12623 Epping Rd Silver Spring MD 20906-3865 Ph: (617) 777-0764 |
| NPI Number | 1669072633 |
|---|---|
| Provider Enumeration Date | 10/29/2020 |
| Last Update Date | 10/29/2020 |
| Certification Date | 10/29/2020 |
| Medicare PECOS PAC ID | 9234535444 |
|---|---|
| Medicare Enrollment ID | O20210913002345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669072633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Chekwube Jacinta Nwabueze |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427697721 PECOS PAC ID: 4789080995 Enrollment ID: I20210913002406 |
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