Individual provider Active NPI

Martha Ebai Atabongakeng

  • Social Worker
  • Washington, DC
National Provider Identifier
1174885263
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LG200004397 Issued in DC
Practice address
6323 Georgia Ave NW Ste 360
Washington, DC 20011-1101
Phone
(202) 621-8494
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Home Health Aide 374U00000X
Social Worker 104100000X LG200004397 DC Primary

Addresses

Primary practice location

6323 Georgia Ave NW Ste 360
Washington, DC 20011-1101

Mailing address

11703 Holly Hock CT
Upper Marlboro, MD 20774-9302
Phone (301) 326-6997

Other practice location 1

2124 Martin Luther King Jr Ave SE
Washington, DC 20020-5732
Phone (202) 563-7632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LG200004397DCMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1174885263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11703 HOLLY HOCK CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749302",
            "telephone_number": "301-326-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 GEORGIA AVE NW STE 360",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111101",
            "telephone_number": "202-621-8494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2124 Martin Luther King Jr Ave SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200205732",
            "country_code": "US",
            "telephone_number": "202-563-7632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATABONGAKENG",
        "first_name": "MARTHA",
        "middle_name": "EBAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG200004397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.