Healthcare Provider Details

I. General information

NPI: 1619232238
Provider Name (Legal Business Name): SYLVIE LUM NIBA PCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 DIX ST NE
WASHINGTON DC
20019-6965
US

IV. Provider business mailing address

5820 DIX ST NE
WASHINGTON DC
20019-6965
US

V. Phone/Fax

Practice location:
  • Phone: 202-547-3870
  • Fax:
Mailing address:
  • Phone: 202-202-5473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC200012668
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: