Healthcare Provider Details

I. General information

NPI: 1194508564
Provider Name (Legal Business Name): DAWN SEANTRYSE KAPFUMVUTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 GOOD HOPE RD SE
WASHINGTON DC
20020-3011
US

IV. Provider business mailing address

2501 GOOD HOPE RD SE
WASHINGTON DC
20020-3011
US

V. Phone/Fax

Practice location:
  • Phone: 202-866-7505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLA50077780
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLG200002848
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: