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)CodeLicenseStatePrimary
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

Other providers in Washington, DC

All providers in Washington, DC · Community/Behavioral Health Agency in District of Columbia

Sources for this page

Verify at the official NPI Registry.