Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy Medical Clinic with Mental Health, LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1912518952

Legacy Medical Clinic with Mental Health, LLC is a Psychiatric/Mental Health Nurse Practitioner in Temple Hills, Maryland. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4700 Stamp Rd Ste K
Temple Hills, MD 20748-6717
Phone: (301) 880-4900
Fax: (301) 477-4673
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1912518952
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chuks Nwaulu — Owner Of The Entity · (301) 880-4900
NPI enumeratedAugust 13, 2020
Last updated in NPPESAugust 13, 2020
Certification dateAugust 13, 2020
Mailing address9509 Manor Oaks Vw, Upper Marlboro, MD 20772-3192

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