Healthcare Provider Details
I. General information
NPI: 1316201684
Provider Name (Legal Business Name): ADOLF ENOH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/01/2012
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1303 L'ENFANT SQUARE
SE DC
20020
US
IV. Provider business mailing address
9400 GRAND BLVD APT 2256
LARGO MD
20774-2654
US
V. Phone/Fax
- Phone: 202-269-2401
- Fax: 202-544-8216
- Phone: 404-992-0332
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | CACII200001303 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: