Healthcare Provider Details

I. General information

NPI: 1528755055
Provider Name (Legal Business Name): ANITA EMENKENG ATEMNKENG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9105 TALLFIELD CT
LANHAM MD
20706-3381
US

IV. Provider business mailing address

9105 TALLFIELD CT
LANHAM MD
20706-3381
US

V. Phone/Fax

Practice location:
  • Phone: 301-393-7154
  • Fax:
Mailing address:
  • Phone: 301-393-7154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCACII200001307
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: