Provider Demographics
NPI:1043384480
Name:SHEKU, MOMODU (LCPC)
Entity Type:Individual
Prefix:
First Name:MOMODU
Middle Name:
Last Name:SHEKU
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 RIGGS RD STE 215
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4246
Mailing Address - Country:US
Mailing Address - Phone:301-257-0256
Mailing Address - Fax:
Practice Address - Street 1:7411 RIGGS RD
Practice Address - Street 2:STE 215
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-4246
Practice Address - Country:US
Practice Address - Phone:301-257-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC147101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional