Moundu Agien Cyprian
Individual provider Active NPI Community/Behavioral Health Agency · Washington, DC
NPI 1114478377 · NPPES record last updated Jul 17, 2023
Key facts
- NPI
- 1114478377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 2811 Pennsylvania Ave SE
Washington, DC 20020-3865 - Phone
- (202) 894-6811
- NPI assigned
- Oct 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Mailing address
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Phone (202) 894-6811
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All providers in Washington, DC · Community/Behavioral Health Agency in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.