Provider Demographics
NPI:1871927079
Name:NDICHU, ERIC WANJAMAH (LICSW)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:WANJAMAH
Last Name:NDICHU
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15005 ATHEY RD
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1645
Mailing Address - Country:US
Mailing Address - Phone:202-604-5681
Mailing Address - Fax:
Practice Address - Street 1:99 SOLDIERS LN # PA
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2550
Practice Address - Country:US
Practice Address - Phone:202-528-7137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-25
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040147251041C0700X
DCLC500797641041C0700X
MD174311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical