Provider Demographics
NPI:1063004885
Name:AKOMA ( FROM THE HEART) MENTAL HEALTH CONSULTING
Entity Type:Organization
Organization Name:AKOMA ( FROM THE HEART) MENTAL HEALTH CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:240-535-4818
Mailing Address - Street 1:7100 CHESAPEAKE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2353
Mailing Address - Country:US
Mailing Address - Phone:240-535-4818
Mailing Address - Fax:215-525-0272
Practice Address - Street 1:7100 CHESAPEAKE RD STE 201
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2353
Practice Address - Country:US
Practice Address - Phone:240-535-4818
Practice Address - Fax:215-525-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty