Healthcare Provider Details

I. General information

NPI: 1679308878
Provider Name (Legal Business Name): SIMEON EMMANUEL TCHAMEU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 MINNESOTA AVE SE
WASHINGTON DC
20019-1127
US

IV. Provider business mailing address

4657 PEBBLESHIRE CT
WALDORF MD
20602-4108
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-5310
  • Fax: 202-810-9189
Mailing address:
  • Phone: 202-820-2141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: