Organization
ICON CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THICKNESS PATRICK EGWUATU BC-PMHNP (PROVIDER/CEO)
(202) 288-7752
Entity
Organization
Contact information
Practice address
7735 BELLE POINT DR, GREENBELT, MD 20770-3300
(240) 455-3166
(240) 455-4154
Mailing address
7735 BELLE POINT DR, GREENBELT, MD 20770-3300
(240) 455-3166
(240) 455-4154
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/13/2021
Last updated
04/30/2026
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