LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC
NPI 1487272910
Nurse Practitioner - Psychiatric/Mental Health in Temple Hills, MD

Q: 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.

Active since July 10, 2020

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

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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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 1487272910) is a healthcare organization registered as a psychiatric/mental health in Temple Hills, Maryland and active in the NPI registry since July 2020. The organization maintains a secondary practice location in Annapolis and lists Chinasa L Nwaulu, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1487272910

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

Phone(301) 880-4900

Organization SubpartNo

Authorized OfficialChinasa L NwauluCo-owner · (301) 880-4900

Enumeration DateJuly 10, 2020

Last NPPES UpdateFebruary 13, 2024

NPPES CertifiedFebruary 13, 2024

✔ NPI 1487272910 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

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Secondary Practice Location 1

Location 11203 West StAnnapolis, MD 21401-3662 · Phone (410) 263-4366 · Fax (410) 268-5597

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.

UZOCHIAMAKA NDUKWU

Nurse Practitioner (Psychiatric/Mental Health)