Leadeth Stillwaters
Nurse Practitioner, Psych/Mental Health in Washington, DC. Organization (NPI-2).
Details
- NPI
- 1497467641
- Entity type
- Organization (NPI-2)
- Legal business name
- Leadeth Stillwaters
- Organization subpart
- No
- Enumeration date
- Dec 20, 2022
- Certification date
- Jun 5, 2026
- Last updated
- Jun 5, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
712 H St Ne Ste 1628Washington, DC 20002-3627
Phone 301-265-5922
Mailing address
9461 Charleville Blvd Ste 1216Beverly Hills, CA 90212-3017
Phone 301-265-5922 · Fax 475-275-7541
Authorized official
Fatima Muna Koroma
Ceo
5712771111
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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