Provider Demographics
NPI:1891982013
Name:NWOGBURU, CHINEDU OKO (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHINEDU
Middle Name:OKO
Last Name:NWOGBURU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 MAPLE CLUSTER CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7195
Mailing Address - Country:US
Mailing Address - Phone:757-391-6581
Mailing Address - Fax:757-391-6560
Practice Address - Street 1:825 CRAWFORD PKWY
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2301
Practice Address - Country:US
Practice Address - Phone:757-391-6581
Practice Address - Fax:757-391-6560
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701004260OtherBOARD OF COUNSELING