Healthcare Provider Details

I. General information

NPI: 1184568875
Provider Name (Legal Business Name): SUSIE ASAMOAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 MINNESOTA AVE NE
WASHINGTON DC
20019-2662
US

IV. Provider business mailing address

4851 ELLIN RD APT 265
HYATTSVILLE MD
20784-1775
US

V. Phone/Fax

Practice location:
  • Phone: 646-750-1292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200004723
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: