LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC
NPI 1174388771
Nurse Practitioner - Psychiatric/Mental Health in Temple Hills, MD

Active since February 14, 2024
4700 STAMP RD STE K, TEMPLE HILLS, MD 20748(301) 880-4900 Get Directions Write a Review

NPPES record last updated: February 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Medical Clinic With Mental Health, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC (NPI 1174388771) is a healthcare organization registered as a psychiatric/mental health in Temple Hills, Maryland and active in the NPI registry since February 2024. The organization maintains a secondary practice location in Annapolis and lists Chuks Nwaulu, Owner, as its authorized official.

NPPES Registry Identity

NPI1174388771
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameLEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC
Location Address4700 STAMP RD STE KTemple Hills, MD 20748-6717
Mailing Address9509 Manor Oaks VwUpper Marlboro, MD 20772-3192
Organization SubpartNo
Authorized OfficialChuks NwauluOwner · (240) 422-0687
Enumeration DateFebruary 14, 2024
NPPES CertifiedFebruary 13, 2024
NPI 1174388771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
4700 STAMP RD STE K, Temple Hills, MD 20748

Secondary Practice Location 1

Location 11203 West StAnnapolis, MD 21401-3662 · Phone (410) 263-4366

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
4700 STAMP RD STE K
TEMPLE HILLS, MD 20748
Nurse Practitioner (Family)
4700 STAMP RD STE K
TEMPLE HILLS, MD 20748
Nurse Practitioner (Psychiatric/Mental Health)
4700 STAMP RD STE K
TEMPLE HILLS, MD 20748
Nurse Practitioner (Psychiatric/Mental Health)
4700 STAMP RD STE K
TEMPLE HILLS, MD 20748
Nurse Practitioner (Psychiatric/Mental Health)
4700 STAMP RD STE K
TEMPLE HILLS, MD 20748

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Medical Clinic With Mental Health, LLC's NPI number?

The NPI number for Legacy Medical Clinic With Mental Health, LLC is 1174388771. It was assigned to this organization in the NPPES registry on February 14, 2024.

Where is Legacy Medical Clinic With Mental Health, LLC located?

Legacy Medical Clinic With Mental Health, LLC is located at 4700 Stamp Rd Ste K, Temple Hills, MD 20748. The listed phone number is (301) 880-4900.

What is Legacy Medical Clinic With Mental Health, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Legacy Medical Clinic With Mental Health, LLC was last updated on February 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.