Individual provider Active NPI

Fatmata B Tejan

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1083313001
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC200004146 Issued in DC
Practice address
1221 Taylor St NW
Washington, DC 20011-5617
Phone
(202) 388-4300
NPI assigned
Feb 28, 2023
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LC200004146 DC
Clinical Social Worker 1041C0700X LC200004146 DC Primary
School Social Worker 1041S0200X NU

Addresses

Primary practice location

1221 Taylor St NW
Washington, DC 20011-5617

Mailing address

11706 Wynnifred PL
Glenn Dale, MD 20769-9482
Phone (240) 422-4768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021004009 DC Practitioner - Clinical Social Worker 6204324320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mbi Health Services LLCGroup PAC ID 5294990453, 20 clinicians

Practice addresses (Care Compare)

4017 Minnesota Ave NE
Mbi Health Services Central Intake
Washington, DC 20019-3541
Phone (202) 388-9202

4130 Hunt PL NE
Washington, DC 20019-3565
Phone (202) 388-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC200004146DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Healing Center Clinical CurrentSince Dec 7, 2025 Accepting new patients
Mbi Health Services LLC CurrentSince Sep 2, 2025 Accepting new patients

Locations

1221 Taylor St NW
Washington, DC 20011
Phone (202) 464-9200

4017 Minnesota Ave NE
Washington, DC 20019
Phone (202) 388-9202

4130 Hunt Pl NE
Washington, DC 20019
Phone (202) 388-4320

7200 Wisconsin Ave
Ste 702
Bethesda, MD 20814
Phone (202) 215-5348

4329 Northview Dr
Bowie, MD 20716
Phone (240) 422-4768

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1083313001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11706 WYNNIFRED PL",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699482",
            "telephone_number": "240-422-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 TAYLOR ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115617",
            "telephone_number": "202-388-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJAN",
        "first_name": "FATMATA",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LC200004146",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200004146",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.