Healthcare Provider Details
I. General information
NPI: 1356105738
Provider Name (Legal Business Name): CITYWORLD FAMILY PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2024
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7700 OLD BRANCH AVE STE B201
CLINTON MD
20735-1605
US
IV. Provider business mailing address
7700 OLD BRANCH AVE STE B201
CLINTON MD
20735-1605
US
V. Phone/Fax
- Phone: 301-289-7722
- Fax: 301-441-2518
- Phone: 301-289-7722
- Fax: 301-441-2518
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MBUTAMBE
ARREY
AKPANG
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 202-658-6844