SHINING PATH WELLNESS CLINIC LLC NPI 1851277370

NPI Information

  • NPI: 1851277370
  • Provider Name: SHINING PATH WELLNESS CLINIC LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 12345 PARKLAWN DR STE 200
    ROCKVILLE, MD
    ZIP 20852
  • Phone: (301) 355-3145

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NPI Details

SHINING PATH WELLNESS CLINIC LLC is a psychiatric/mental health nurse practitioner in Rockville, MD. SHINING PATH WELLNESS CLINIC LLC NPI is 1851277370. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12345 PARKLAWN DR STE 200
ROCKVILLE, MD
ZIP 20852-725
Phone: (301) 355-3145

The provider's authorized official is Afusat Deng .
The authorized official title is Owner and has the following contact phone number (332) 330-3903.

The enumeration date for this NPI number is 8/12/2025 and was last updated on 12/3/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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