DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: FIDELIS N SAB CAC II

MEDICARE: FIDELIS N SAB CAC II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
2101Y00000XCounselorCACII200001262
3101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1023377694
Entity Type Code : Individual
Provider Name (Legal Business Name) : FIDELIS N SAB CAC II
Provider Business Mailing Address
First Line : 7903 ORION CIR APT C215
Second Line :
City : LAUREL
State : MD
Zip : 20724-3101
Country : US
Telephone Number : 240-350-9677
Fax Number :
Provider Business Practice Location Address
First Line : 3109 MARTIN LUTHER KING JR AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20032-1573
Country : US
Telephone Number : 202-800-4433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2012
Last Update Date : 03/25/2026

Similar Medicare Providers

1235494808 — TEBIT BRITA AKOM
Practice Location Address:
3109 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC
20032-1573
Practice Phone: 202-800-4433
Practice Fax:
1255990032 — BRIANNA SANDERS LGPC
Practice Location Address:
3109 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC
20032-1573
Practice Phone: 202-800-4433
Practice Fax:
1851054175 — MS. CLAUDINE NANA TCHAPCHET CSA
Practice Location Address:
3109 MLK JR AVE SE
WASHINGTON, DC
20032-1573
Practice Phone: 202-800-4433
Practice Fax:
1245934918 — OLUGBENGA JOSEPH AJAYI
Practice Location Address:
3109 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC
20032-1573
Practice Phone: 202-800-4433
Practice Fax:
1467156182 — TIARA LISTON
Practice Location Address:
3109 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC
20032-1573
Practice Phone: 202-800-4433
Practice Fax:
1952006041 — BLESS TANYI
Practice Location Address:
3109 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC
20032-1573
Practice Phone: 804-665-8890
Practice Fax:

Directions to “ FIDELIS N SAB CAC II” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.