Provider Demographics
NPI:1083193114
Name:NKENGAKA, AKAMIN VICTOR (PHD, LCSW, LMSW)
Entity Type:Individual
Prefix:DR
First Name:AKAMIN
Middle Name:VICTOR
Last Name:NKENGAKA
Suffix:
Gender:M
Credentials:PHD, LCSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 LAURELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3045
Mailing Address - Country:US
Mailing Address - Phone:318-294-8877
Mailing Address - Fax:
Practice Address - Street 1:5410 MARYLAND WAY
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5064
Practice Address - Country:US
Practice Address - Phone:855-212-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCI12800718101YA0400X
LA10551101YM0800X
DEQ0000185101YP2500X
GAG0088171M00000X
RICSW031861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1255705901OtherNATIONAL PROVIDER IDENTIFICATION