Healthcare Provider Details

I. General information

NPI: 1205766839
Provider Name (Legal Business Name): MR. JOHN ARREY NDOHTABI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 EASTERN AVE NE
WASHINGTON DC
20019-2833
US

IV. Provider business mailing address

6408 CIPRIANO RD
LANHAM MD
20706-3968
US

V. Phone/Fax

Practice location:
  • Phone: 202-248-1356
  • Fax: 202-978-5970
Mailing address:
  • Phone: 202-281-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: